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A history of airplane travel triggering symptoms might lead one to consider either perilymph fistula or MdDS, but classic perilymph fistula presents with a sudden “popping” noise in the ear and is soon followed by hearing loss, vertigo, and tinnitus.12 Again, MdDS could begin following a history of air travel but it would not present with hearing changes

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The jaundice (R17) may be listed additionally if separately documented as a clinical finding