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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

Furthermore, creating individualized treatment plans based on lifestyle, metabolic, and genetic variables may improve the efficacy of natural supplements and exercise