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.
|Number of pages||4|
|Journal||Journal of International Dental and Medical Research|
|Publication status||Published - 1 Jan 2017|
- Chronic Suppurative Otitis Media
- Middle Ear. Pepsin Level