Article
Detection of Extraesophageal Reflux in Children with Chronic Otitis Media with Effusion
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Published: | April 14, 2014 |
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Introduction: Recent studies have showed that EER plays important role in the pathogenesis of refractory rhinosinusitis and is considered as one of the causes of otitis media as well. Besides pH monitoring and esophageal impedance monitoring, new diagnostics methods such as 24 hour orofaryngeal pH monitoring (Restech® system), detection of pepsin in secretion (Peptest) and imunohistochemical detection of pepsin in biopsy have become available.
Methods: Aim of our prospective study was detection of EER in children with chronic otitis media with effusion, who underwent adenoidectomy and myringotomy with or without tympanostomy. Oropharyngeal pH was monitored before surgery (Restech® system). Detection of pepsin in middle ear secretion and in biopsy of adenoids was performed after the surgery.
Results: 19 children (at the age of 1 to 9 years) were examined in ENT department of University Hospital Ostrava from November 2012 to November 2013. Restech® examination showed EER in 12/18 (66.7%) patients. Pepsin in the middle ear secretion was detected by Peptest in 5/18 (27.8 %) patients. No specimen of adenoids was positive for pepsin using imunohistocemical examination.
Conclusion: EER could play some role in the pathogenesis of chronic otitis media with effusion in 30-70% of children. Diagnosis of EER by Restech and Peptest is simple and very well tolerated. Imunohistochemical detection of pepsin in biopic specimen of adenoids is not suitable for diagnostic of EER. Patients with EER could potentially profit from anti-reflux therapy, but further studies are required regarding this issue.
Unterstützt durch: MZCR č. 1 RVO-FNOs/2012, č. 2 RVO-FNOs/2013, IGAMZCR NT13500-4/2012
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