Prospective Study on the Incidence of Chronic Ear Complaints Related to Gastroesophageal Reflux and on the Outcome of Antireflux Therapy

• Published in: Annals of otology, rhinology & laryngology Vol. 111; no. 10; pp. 933 - 938
• Main Authors: Poelmans, Johan, Tack, Jan, Feenstra, Louw
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.10.2002; Annals Publishing Compagny; SAGE PUBLICATIONS, INC
• Subjects: Adult; Aged; Anti-Ulcer Agents - administration & dosage; Anti-Ulcer Agents - therapeutic use; Biological and medical sciences; Chronic Disease; Cohort Studies; Digestive system; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Enzyme Inhibitors - administration & dosage; Enzyme Inhibitors - therapeutic use; Female; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - diagnosis; Gastroesophageal Reflux - drug therapy; Humans; Male; Manometry; Medical sciences; Middle Aged; Non tumoral diseases; Omeprazole - administration & dosage; Omeprazole - therapeutic use; Otitis Media with Effusion - diagnosis; Otitis Media with Effusion - epidemiology; Otitis Media with Effusion - etiology; Otorhinolaryngology. Stomatology; Pharmacology. Drug treatments; Prospective Studies; Time Factors; Treatment Outcome; chronic secretory otitis media; extraesophageal reflux; gastroesophageal reflux; Middle ear disease; Esophageal disease; H; Antiulcer agent; K; Incidence; Proton pump inhibitor; Prospective; Pain; Antisecretory agent; ENT disease; Biological effect; Endoscopy; Human; Gastroesophageal reflux; Effusion; Enzyme; Ear disease; Enzyme inhibitor; Omeprazole; pH metering; Chemotherapy; Chronic; Treatment; Benzimidazole derivatives; Ear; Digestive diseases; Hydrolases; exchanging ATPase; Otitis media
• ISSN: 0003-4894; 1943-572X
• DOI: 10.1177/000348940211101013

Over a 2-year period (1997 to 1999), 5 consecutive adult patients with chronic refractory secretory otitis media (CSOM) and 16 with a chronic refractory feeling of pressure in the ear(s) (CRFP) thought to be related to concomitant eustachian tube dysfunction were prospectively studied for coexisting gastroesophageal reflux (GER). All patients underwent an extensive standardized otorhinolaryngological examination, ambulatory 24-hour dual-probe esophageal pH monitoring with a distal pH probe 5 cm and a proximal probe 20 cm above the lower esophageal sphincter, and upper gastrointestinal endoscopy. Most of them also underwent esophageal manometry. All patients with CSOM and 12 of the 16 patients with CRFP had evidence of GER. Only 5 patients experienced heartburn or regurgitation. All patients responded very well to antireflux therapy with omeprazole 20 mg twice per day (40 mg twice per day in 2 patients) accompanied by conservative antireflux measures, ie, complete cessation of their middle ear complaints. This study demonstrates the role of GER in the pathogenesis of refractory CSOM and CRFP and the effectiveness of sustained antireflux therapy.