Popping sound and streaming water-like tinnitus in Cochlin-tomoprotein-confirmed perilymphatic fistula with antecedent barotrauma

Perilymphatic fistula (PLF) after barotrauma has been linked to popping sounds, streaming water-like tinnitus, and fistula signs, but objective evidence is limited. AIMS/OBJECTIVES: To determine whether these features are associated with Cochlin-tomoprotein (CTP)-confirmed PLF after antecedent barotrauma.

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Cochlin-tomoprotein testing may support diagnosis of perilymphatic fistula in patients presenting with unusual tinnitus after barotrauma, but this is a single case report and no actionable change to routine clinical practice is warranted at this time.

This case highlights Cochlin-tomoprotein as a potentially useful biomarker for confirming perilymphatic fistula, a notoriously difficult diagnosis, which could eventually reduce diagnostic uncertainty in barotrauma-related tinnitus presentations.

1. 01Single case of perilymphatic fistula confirmed via Cochlin-tomoprotein (CTP) testing after barotrauma.
2. 02Patient presented with distinctive tinnitus: popping sounds and streaming water-like sensation.
3. 03CTP is a middle-ear fluid biomarker that can objectively confirm inner-ear fluid leakage.
4. 04Objective evidence in this case was limited, consistent with the diagnostic challenge of perilymphatic fistula.
5. 05Published in Frontiers in Neurology (PMID 42723732).

PMID

42723732

DOI

10.3389/fneur.2026.1939108.

Journal

Frontiers in Neurology

Publication type

case_report

Evidence level

4

Sample size

1

Population

Individual patient with perilymphatic fistula following barotrauma

Intervention

Cochlin-tomoprotein (CTP) testing for perilymphatic fistula diagnosis