The relation of reflux finding score and reflux symptom index with middle ear pepsin level in chronic suppurative otitis media

Ayu Astria Sriyana, Susyana Tamin, Syahrial M. Hutahuruk, Saptawati Bardosono, Ina Susianti Timan, Ratna Dwi Restuti

Research output: Contribution to journalArticle

Abstract

Laryngopharyngeal reflux is one of the factors that contribute to the development of chronic otitis media; however, its role in chronic suppurative otitis media (CSOM) remains unclear. Previous studies showed that refluxate could reach the middle ear, and reported the presence of pepsin, a marker of extraesophageal reflux, in the middle ear, where it may play inflammatory role. In CSOM patients with laryngopharyngeal reflux, refluxate may reach the middle ear and play a role in middle ear inflammation and infection. This study aimed to investigate the relation of reflux finding score (RFS) and reflux symptom index (RSI) with middle ear pepsin level as a predictor of reflux into the middle ear in CSOM patients. In this cross-sectional study, we analyzed RFS, RSI, and pepsin levels in the middle ear as markers of laryngopharyngeal reflux in CSOM patients. Forty-two subjects (21 male, 21 female) were enrolled via consecutive sampling. RFS was measured by two different blinded reviewers using recorded video. Middle ear pepsin levels were measured using a Human Pepsin ELISA Kit Cusabio (CSB-E08919h). Results: Pepsin was detected in the middle ear in 25 (59.5%) patients with CSOM. Mean middle ear pepsin levels were significantly higher in patients with positive RFS than in those with negative RFS (p < 0.05). Compared to patients with negative RFS, patients with positive RFS had a 5.13-fold higher risk of pepsin in the middle ear (CI 95%=1.095-24.073). RSI was not correlated with middle ear pepsin levels. Pepsin was detected in the middle ear in more than half the study participants, and RFS ≥ 7 was significantly correlated with increased risk of pepsin in the middle ear. These results suggest that the role of laryngopharyngeal reflux in CSOM warrants further investigation.

Original languageEnglish
Pages (from-to)1048-1051
Number of pages4
JournalJournal of International Dental and Medical Research
Volume10
Issue number3
Publication statusPublished - 1 Jan 2017

Keywords

  • Chronic Suppurative Otitis Media
  • Middle Ear. Pepsin Level
  • Reflux

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