Laryngopharyngeal Reflux in Children with Chronic Otitis Media with Effusion

Abstract

Background/AimsTo evaluate the characteristic properties of laryngopharyngeal reflux (LPR) and gastroesophageal reflux (GER) in children with otitis media with effusion (OME) using 24-hour multichannel intraluminal impedance combined with dual-probe (pharyngeal and esophageal) pH-metry. MethodsChildren aged 7-10 years of age with OME underwent 24-hour multichannel intraluminal impedance pH-metry. The upper pH sensor was situated 1 cm above the upper esophageal sphincter, and the lower pH sensor was placed 3-5 cm above the lower esophageal sphincter. Parents were asked to complete the gastroesophageal reflux assessment of symptoms in a pediatrics questionnaire. ResultsTwenty-eight children were enrolled; LPR was detected in 19 (67.9%) children. The criteria of the LPR diagnosis was the presence of at least one supraesophageal episode with a pH < 5.0 and a change in the pH value measured from the initial level at the upper sensor of > 0.2. In total, 64 episodes were observed. Assessment of all LPR episodes showed the presence of 246 episodes in the entire study. A considerable predominance of weakly acidic episodes (87.8%) was noted; there were 6.5% acidic episodes, and weakly alkaline episodes reached 5.7%. Pathological GER was noted in 10 (35.7%) subjects. Acid GER was detected in 8 children, 2 of whom demonstrated non-acidic reflux. In the LPR-negative patients, no pathological GER was confirmed with the exception of a single case of non-acidic reflux. ConclusionsLPR was frequently noted in the group of children with OME, and it might be an important risk factor in this common disease.

Combined multichannel intraluminal impedance‐pH monitoring should be used to diagnose reflux‐related otitis media with effusion in children

“… , extraoesophageal reflux is probably one of the aetiological factors in as many as one‐third of the children with OME. That statement is absolutely in line with the results of our study and the results of a previously cited study from Poland . All these studies used MII‐pH monitoring to evaluate children with OME, emphasising further its usefulness in the diagnosis of GER‐related OME.…”

“…In 2016, Górecka‐Tuteja et al. investigated 28 children aged 7–10 years of age with OME using MII‐pH monitoring and found pathological GER in 35.7% of the children. These data in that study were in accordance with our findings, as we found that 35% of children had GERD but, interestingly, we found a higher proportion of weakly acidic GER episodes.…”

Clinical Manifestations of Laryngopharyngeal Reflux

“…LPR is considered one of the risk factors of OM. In the study by Górecka-Tuteja et al, 10 19 of 28 children (68%) with OM had LPR, which is similar to the results found in previous studies (mean 49%, range 27-71%). 8 Therefore, the authors suggest that LPR is an important risk factor of OM in children.…”

Can Reflux Symptom Index and Reflux Finding Score Be Used to Guide the Treatment of Secretory Otitis Media in Adults?

“…the eustachian tube may be attributed to mucosal inflammation, toxicity, and osmosis of bile acid in an acidic environment after LPRD [17]. LPRD is associated with the occurrence and progress of secretory otitis media [18], and it can make secretory otitis media progress more rapidly [19]. Obesity is one of the influencing factors of LPRD, and patients with an abnormal BMI often have a high risk of LPRD [20].…”