Related Experiment Video
Updated: Aug 18, 2026

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Gastric reflux is uncommon in acute post-tympanostomy otorrhea
Patrick J Antonelli1, Kristen M Lloyd, James C Lee
1University of Florida, Department of Otolaryngology, Gainesville, FL 32610-0264, USA. antopj@ent.ufl.edu
Objective:
Acute post-tympanostomy otorrhea (APTO) is a common complication of tympanostomy tube placement. APTO has been related primarily to viral upper respiratory infections and external ear contamination. Elevated levels of gastric enzymes have been found in a large proportion of chronic middle ear effusions, implicating gastric reflux (GR) in its pathogenesis. Thus, our objective was to determine whether GR may be a contributing factor in the development of APTO.
Study Design And Setting:
Prospective, nonrandomized design. Otorrhea samples were collected from children with APTO. Total pepsinogen concentrations were measured with a commercial ELISA, using a pepsinogen I-specific capture antibody and horseradish peroxidase detection antibody.
Results:
Twenty-six samples from 24 patients were collected and analyzed. Eight samples demonstrated measurable pepsinogen I, but the measured concentrations, 2-17 mg/L, were below the normal serum reference ranges.
Conclusions:
GR does not play a major role in the development of APTO in children.
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