Role of Laryngopharyngeal Reflux in the Pathogenesis of Otitis Media with Effusion

Doğru, Mehmet; Kuran, Gökhan; Haytoğlu, Süheyl; Dengiz, Ramazan; Arıkan, Osman Kürşat

doi:10.5152/iao.2015.642

Cited by 34 publications

(35 citation statements)

References 22 publications

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“…The link between GOR and OME has been suspected ever since pepsins and Helicobacter pylori were found in samples of middle ear effusion (Formanek et al., 2015; Dogru et al., 2015). However, a direct causal relationship between GOR and OME has not been demonstrated (Miura et al., 2012; Morinaka et al., 2005).…”

Section: The Physiopathology Of Omementioning

confidence: 99%

Otitis media with effusion in children: Pathophysiology, diagnosis, and treatment. A review

2019

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Otitis media with effusion (OME) is a frequent paediatric disorder. The condition is often asymptomatic, and so can easily be missed. However, OME can lead to hearing loss that impairs the child's language and behavioural development. The diagnosis is essentially clinical, and is based on otoscopy and (in some cases) tympanometry. Nasal endoscopy is only indicated in cases of unilateral OME or when obstructive adenoid hypertrophy is suspected. Otitis media with effusion is defined as the observation of middle-ear effusion at consultations three months apart. Hearing must be evaluated (using an age-appropriate audiometry technique) before and after treatment, so as not to miss another underlying cause of deafness (e.g. perception deafness). Craniofacial dysmorphism, respiratory allergy and gastro-oesophageal reflux all favour the development of OME. Although a certain number of medications (antibiotics, corticoids, antihistamines, mucokinetic agents, and nasal decongestants) can be used to treat OME, they are not reliably effective and rarely provide long-term relief. The benchmark treatment for OME is placement of tympanostomy tubes (TTs) and (in some cases) adjunct adenoidectomy. The TTs rapidly normalize hearing and effectively prevent the development of cholesteatoma in the middle ear. In contrast, TTs do not prevent progression towards tympanic atrophy or a retraction pocket. Adenoidectomy enhances the effectiveness of TTs. In children with adenoid hypertrophy, adenoidectomy is indicated before the age of 4 but can be performed later when OME is identified by nasal endoscopy. Children must be followed up until OME has disappeared completely, so that any complications are not missed.

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Section: The Physiopathology Of Omementioning

confidence: 99%

Otitis media with effusion in children: Pathophysiology, diagnosis, and treatment. A review

2019

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“…The current survey reveals similar lack of awareness of the potential role of LPR in development of laryngotracheal stenosis and chronic media otitis, despite an increasing literature which supports this relationship. 10,11,26,27 Surprisingly, non-laryngologists seem to be unaware about the role of LPR in bronchial diseases such as asthma; however, many studies have demonstrated that LPR is involved in the development of bronchial hypersensitivity conditions, such as asthma, 28,29 or chronic obstructive pulmonary disease. 30 In the current survey, the largest differences between laryngologists and non-laryngologists concern diagnostic approach towards LPR, particularly with regard to examinations such as esophagoscopy and MII-pH.…”

Section: Discussionmentioning

confidence: 99%

Do Laryngologists and General Otolaryngologists Manage Laryngopharyngeal Reflux Differently?

et al. 2020

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Objective To investigate current practices of laryngologists and non‐laryngologists in management of Laryngopharyngeal Reflux (LPR). Methods An online survey was sent to members of otolaryngology societies about LPR, and subgroup analysis was performed between laryngologists and non‐laryngologists. This survey was conducted by the LPR Study Group of Young Otolaryngologists of the International Federation of Otolaryngological Societies. Results A total of 535 otolaryngologists completed the survey. Among them, 127 were laryngologists and 408 were non‐laryngologists. Collectively, symptoms most commonly attributed to LPR are cough after lying down/meal, throat clearing, and acid brash; most common findings are thought to be arytenoid erythema and posterior commissure hypertrophy. Respectively, 12.5% and 5% of non‐laryngologists and laryngologists believe that ≥50% of LPR patients suffer from heartburn (P = .010). Non‐laryngologists are more aware about some extra‐laryngeal findings associated with LPR (eg, pharyngeal erythema) than laryngologists. Neither laryngologists nor non‐laryngologists associated development of benign lesions of the vocal folds with reflux. The management of LPR substantially differs between groups, with laryngologists indicating increased awareness of (impedance)‐pH monitoring as well as the prevalence and treatment of nonacid/mixed LPR. Conversely, non‐laryngologists are much more likely to include gastroenterology referral in their management of presumed LPR. Respectively, 44.8% and 27.6% of non‐laryngologists and laryngologists believe themselves not sufficiently knowledgeable about LPR. Conclusions Significant differences exist between laryngologists and non‐laryngologists in diagnosis and treatment of LPR. Overall only one‐third of responders believe themselves to be sufficiently educated about LPR. Level of Evidence 4 Laryngoscope, 130:E539–E547, 2020

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“…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].…”

Section: Discussionmentioning

confidence: 99%

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

Pang

et al. 2020

ORL

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Background: At present more attention is paid to the treatment of secretory otitis media in children, but there is also a high incidence of adult patients. The etiology of secretory otitis media in adults is complex and related to many factors. Objectives: The aim of this study was to evaluate the correlation between the Reflux Symptom Index (RSI)/Reflux Finding Score (RFS) and secretory otitis media in adults, and to explore further treatment methods. Material and Methods: Taking outpatients in the otology department from January 2017 to May 2019 as the object of study, acoustic immittance tests were performed and the results analyzed. Patients with secretory otitis media received tympanocentesis or tympanotomy and the related components were analyzed. The patients were followed up and the curative effects of different treatment schemes were compared. Results: There were 67 patients with secretory otitis media. The prevalence of secretory otitis media in patients with RSI > 13 was significantly higher than that in patients with RSI < 13. The prevalence of secretory otitis media in patients with RFS > 7 was significantly higher than that in patients with RFS < 7 (p < 0 05). The RSI/RFS score of B tympanogram was significantly higher than that of A and C maps (p < 0.05). Among the patients with type B, the serous type was higher in those with an RSI score < 13, and the mucus was higher in those with an RSI score > 13 (p < 0.05). There was no significant difference in the proportion of glue patients (p > 0.05). In type B patients, the detection rate of pepsin in the experimental group was significantly higher than that in the control group (p < 0.05), and the scores of RSI/RFS in the pepsin-positive group were significantly higher than those in the negative group (p < 0.05). Treatment with acid-suppressive drugs in patients with abnormal RSI/ RFS achieved better results (p < 0.05). Conclusions: RSI/RFS may be related to the development of secretory otitis media in adults, and could play a guiding role in its treatment.

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Role of Laryngopharyngeal Reflux in the Pathogenesis of Otitis Media with Effusion

Cited by 34 publications

References 22 publications

Otitis media with effusion in children: Pathophysiology, diagnosis, and treatment. A review

Otitis media with effusion in children: Pathophysiology, diagnosis, and treatment. A review

Do Laryngologists and General Otolaryngologists Manage Laryngopharyngeal Reflux Differently?

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

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