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Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
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Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring

Published on: December 14, 2020

Association of reflux with otitis media in children

Judith E C Lieu1, P Ganesh Muthappan, Ravindra Uppaluri

  • 1Department of Otolaryngology--Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA. lieuj@ent.wustl.edu

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|September 7, 2005
PubMed

Insights

Pepsin/pepsinogen was found in middle ear fluid of children with otitis media with effusion (OME) or recurrent otitis media (ROM). However, increased gastroesophageal reflux (GER) symptoms were not observed in these children.

Area of Science:

  • Otolaryngology
  • Pediatrics
  • Gastroenterology

Background:

  • Otitis media with effusion (OME) and recurrent otitis media (ROM) are common in children.
  • Gastroesophageal reflux (GER) has been hypothesized as a potential contributing factor to OME/ROM.
  • Previous studies suggested the presence of pepsin/pepsinogen in middle ear effusions.

Purpose of the Study:

  • To confirm the presence of pepsin/pepsinogen in middle ear fluid of children diagnosed with OME or ROM.
  • To investigate the association between GER symptoms and OME/ROM in pediatric patients.
  • To further explore the potential link between GER and otitis media.

Main Methods:

  • Middle ear fluid samples were collected from pediatric patients undergoing tympanostomy tube insertion.
  • Pepsin/pepsinogen levels in the collected fluid were quantified using a proteolytic enzyme assay and ELISA.
  • Parental questionnaires were utilized to assess the prevalence and severity of GER symptoms in the children.

Main Results:

  • Pepsin/pepsinogen was detected in a high percentage of middle ear fluid samples (73% by proteolytic assay, 77% by ELISA).
  • Despite the presence of pepsin/pepsinogen, parental reports did not indicate an increased frequency or severity of GER symptoms.
  • No significant correlation was found between GER symptoms and the presence of pepsin/pepsinogen in middle ear fluid.

Conclusions:

  • The study successfully replicated the finding of pepsin/pepsinogen in middle ear effusions of children with OME/ROM.
  • The absence of increased GER symptoms in this cohort suggests that GER may not be a primary driver for OME/ROM in all cases.
  • Further research is warranted to elucidate the precise relationship between GER and otitis media and to establish any potential causative links.
Abstract

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