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Gastric pepsin in middle ear fluid of children with otitis media: clinical implications

Zhaoping He1, Robert C O'Reilly, Devendra Mehta

  • 1Division of Pediatric Otolaryngology, Alfred I. duPont Hospital for Children, Wilmington, DE 19899, USA.

Current Allergy and Asthma Reports
|October 23, 2008
PubMed

Insights

Gastroesophageal reflux may contribute to otitis media, particularly in young children. Studies found gastric pepsin in the middle ear fluid of children with otitis media, suggesting a link between reflux and this common ear infection.

Area of Science:

  • Otolaryngology
  • Gastroenterology
  • Pediatrics

Background:

  • Otitis media is a common childhood illness.
  • Gastroesophageal reflux (GER) and extraesophageal reflux (EER) are suspected contributors to otitis media pathogenesis.
  • Previous research suggests a potential link between refluxate and middle ear inflammation.

Purpose of the Study:

  • To investigate the role of gastroesophageal reflux in the development of otitis media.
  • To determine the presence of gastric components in the middle ear fluid of children with otitis media.

Main Methods:

  • Analysis of middle ear fluid samples from children diagnosed with otitis media.
  • Comparison of samples from a control group of children without otitis media.
  • Detection of gastric pepsin in middle ear effusions using specific assays.

Main Results:

  • Gastric pepsin was detected in the middle ear space of children with otitis media.
  • Gastric pepsin was not found in the middle ear space of control patients.
  • The association between reflux and otitis media was stronger in younger children and those with purulent effusions.

Conclusions:

  • The findings support the hypothesis that gastroesophageal reflux contributes to the pathogenesis of otitis media.
  • Gastric pepsin in the middle ear may indicate microaspiration of refluxate.
  • Further research is warranted to explore therapeutic interventions targeting reflux in otitis media.

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