Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2024, Vol. 38 ›› Issue (6): 131-135.doi: 10.6040/j.issn.1673-3770.0.2024.052

• Clinical Report • Previous Articles    

A case of otitis media associated with pharyngeal reflux with literature review

ZHOU Ying, WANG Gang, WANG Lei, ZHANG Xiaoli, HAN Haolun, LI Baowei, SUN Zhezhe, WU Wei   

  1. Dapartment of Otolaryngology, the Ninth Medical Centerof Chinses PLA General Hospital, Beijing 100101, China
  • Published:2024-12-13

Abstract: Objective To investigate the clinical characteristics, diagnosis and treatment of reflux-associated otitis media. Methods A case of reflux-associated otitis media was reviewed. The patient presented to our hospital with cough and left ear fullness. Laryngopharyngeal reflux was suggested by scale evaluation, pH monitoring, and pepsin was detected in tympanic puncture fluid. The patient was treated with acid inhibition, gastric motility improvement, antiallergics, airway stabilisation, nasal hormone spray, evacuation and atomised inhalation. Results Three months later, the patient's symptoms had disappeared and the test results were normal. The relevant national and international literature was searched to analyse the causes of the disease and the effect of laryngopharyngeal reflux on the airway. Conclusion Laryngopharyngeal reflux may be involved in the pathogenesis of recurrent secretory otitis media, sinusitis and chronic lung disease.

Key words: Secretory otitis media, Pharyngeal reflux disease, Pepsin, Gastro-oesophageal reflux, pH monitoring

CLC Number: 

  • R766.5
[1] 焦雪梅, 杨扬, 李春凤, 等. 鼓膜置管对分泌性中耳炎患儿咽鼓管功能的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 60-63. doi:10.6040/j.issn.1673-3770.0.2020.476 JIAO Xuemei, YANG Yang, LI Chunfeng, et al. Effect of tympanic membrane insertion on the function of eustachian tube in children with secretory otitis media[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 60-63. doi:10.6040/j.issn.1673-3770.0.2020.476
[2] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会. 咽鼓管功能障碍专家共识[J]. 中华耳鼻咽喉头颈外科杂志. 2018, 53(6): 406-409.doi:10.3760/cma.j.issn.1673-0860.2018.06.002
[3] 高信忠, 林宗通, 沈翎, 等. 咽鼓管球囊扩张联合腺样体切除术治疗儿童分泌性中耳炎疗效分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 7-12. doi:10.6040/j.issn.1673-3770.0.2021.506 GAO Xinzhong, LIN Zongtong, SHEN Ling, et al. Analysis of the efficacy of balloon eustachian tuboplasty combined with adenoidectomy in the treatment of otitis media with effusion in children[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 7-12. doi:10.6040/j.issn.1673-3770.0.2021.506
[4] Schilder AGM, Bhutta MF, Butler CC, et al. Eustachian tube dysfunction: consensus statement on definition, types, clinical presentation and diagnosis[J]. Clin Otolaryngol, 2015, 40(5): 407-411. doi:10.1111/coa.12475
[5] 中华耳鼻咽喉头颈外科杂志编辑委员会咽喉组, 中华医学会耳鼻咽喉头颈外科学分会咽喉学组. 咽喉反流性疾病诊断与治疗专家共识(2015年)[J]. 中华耳鼻咽喉头颈外科杂志, 2016, 51(5): 324-326. doi:10.3760/cma.j.issn.1673-0860.2016.05.002
[6] Koufman JA, Aviv JE, Casiano RR, et al. Laryngopharyngeal reflux: position statement of the committee on speech, voice, and swallowing disorders of the American Academy of Otolaryngology-Head and Neck Surgery[J]. Otolaryngol Head Neck Surg, 2002, 127(1): 32-35. doi:10.1067/mhn.2002.125760
[7] Abou-Ismail A, Vaezi MF. Evaluation of patients with suspected laryngopharyngeal reflux: a practical approach[J]. Curr Gastroenterol Rep, 2011, 13(3): 213-218. doi:10.1007/s11894-011-0184-x
[8] 吴华, 孙永明, 郑建华, 等. 腺样体消融联合鼓膜打孔术治疗儿童腺样体肥大合并分泌性中耳炎55例[J]. 山东大学耳鼻喉眼学报, 2021, 35(2): 71-75. doi:10.6040/j.issn.1673-3770.1.2020.097 WU Hua, SUN Yongming, ZHENG Jianhua, et al. Application of endoscopic adenoids cryoablation combined with low-temperature plasma tympanostomy in the treatment of 55 children with adenoid hypertrophy and secretory otitis media[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(2): 71-75. doi:10.6040/j.issn.1673-3770.1.2020.097
[9] Yazici ZM, Sari M, Uneri C, et al. Histologic changes in eustachian tube mucosa of rats after exposure to gastric reflux[J]. Laryngoscope, 2008, 118(5): 849-853. doi:10.1097/MLG.0b013e318164d0c0
[10] Heavner SB, Hardy SM, White DR, et al. Function of the eustachian tube after weekly exposure to pepsin/hydrochloric acid[J]. Otolaryngol Head Neck Surg, 2001, 125(3): 123-129. doi:10.1067/mhn.2001.116448
[11] Wong IWY, Rees G, Greiff L, et al. Gastroesophageal reflux disease and chronic sinusitis: in search of an esophageal-nasal reflex[J]. Am J Rhinol Allergy, 2010, 24(4): 255-259. doi:10.2500/ajra.2010.24.3490
[12] Starosta V, Kitz R, Hartl D, et al. Bronchoalveolar pepsin, bile acids, oxidation, and inflammation in children with gastroesophageal reflux disease[J]. Chest, 2007, 132(5): 1557-1564. doi:10.1378/chest.07-0316
[13] Tasker A, Dettmar PW, Panetti M, et al. Is gastric reflux a cause of otitis media with effusion in children?[J]. Laryngoscope, 2002, 112(11): 1930-1934. doi:10.1097/00005537-200211000-00004
[14] Crapko M, Kerschner JE, Syring M, et al. Role of extra-esophageal reflux in chronic otitis media with effusion[J]. Laryngoscope, 2007, 117(8): 1419-1423. doi:10.1097/MLG.0b013e318064f177
[15] Johnston N, Dettmar PW, Bishwokarma B, et al. Activity/stability of human pepsin: implications for reflux attributed laryngeal disease[J]. Laryngoscope, 2007, 117(6): 1036-1039. doi:10.1097/MLG.0b013e31804154c3
[16] Lieu JEC, Muthappan PG, Uppaluri R. Association of reflux with otitis media in children[J]. Otolaryngol Head Neck Surg, 2005, 133(3): 357-361. doi:10.1016/j.otohns.2005.05.654
[17] O'Reilly RC, He ZP, Bloedon E, et al. The role of extraesophageal reflux in otitis media in infants and children[J]. Laryngoscope, 2008, 118: 1-9. doi:10.1097/MLG.0b013e31817924a3
[18] Galli J, Agostino S, Calò L, et al. Gastro-esophageal reflux and laryngeal phlogistic disorders: clinical evaluation and multi-electrode pH monitoring[J]. Acta Otorhinolaryngol Ital, 2001, 21(5): 306-311
[1] HU Zhiwei, CHEN Dong, YANG Dong, WU Jimin. Diagnosis and treatment of gastroesophageal airway reflux disease: based on related consensus and guidelines from 2020 to 2024 [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 30-38.
[2] ZHAO Jianing, CUI Yuanxin, WANG Dan, ZHAO Ming. Exploration of the relationship between laryngopharyngeal reflux and recurrent respiratory papilloma and its mechanism [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 39-45.
[3] ZHOU Shitong, YANG Yanyan, YANG Yucheng, FANG Hongyan. Pepsin and laryngopharyngeal reflux disease: from pathogenic mechanisms to potential risk factors for pharyngeal and laryngeal squamous cell carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 55-60.
[4] XI Xiaoyu, SUI Xinke, CHEN Sheng, LI Lianyong, ZHONG Changqing. Endoscopic treatment of laryngopharyngeal reflux disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 61-65.
[5] NIU Yanyan, GU Wei, JIN Xiaofeng, HUO Hong, YANG Dahai, CUI Tingting, WANG Jian. Expression analysis of pepsin in vocal cord leukoplakia tissues [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 66-70.
[6] WANG Lei, WANG Gang, SUN Zhezhe, LIU Hongdan, HAN Haolun, LI Baowei, ZHANG Xiaoli, WU Wei. Correlations between vocal cord hyperplastic lesions, vocal cord leukoplakia, chronic laryngopharyngitis, and laryngopharyngeal reflux [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 71-77.
[7] SUN Zhezhe, WANG Gang, WANG Lei, LI Baowei, HAN Haolun, LIU Hongdan, ZHANG Xiaoli, WU Wei. Influence of body positions on laryngopharyngeal reflux disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 91-95.
[8] LI Fengjiang, WEI Jie, LIU Hongdan, ZHANG Li, ZHAO Weichao, WU Nana, WANG Lei, WU Wei, WANG Ruijuan. Gastroesophageal reflux disease and laryngopharyngeal reflux disease in 25 elderly patients with pneumonia [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 103-107.
[9] LIU Xiaohong, ZHANG Qingqing, GUO Ruixin, QIANG Yin, SHI Yao, YANG Haonan, CAO Nan, JIA Wei, XIE Meng. Analysis of reflux types in patients with laryngeal reflux associated with Helicobacter pylori infection [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 108-114.
[10] DU Chen, YAN Yan, WANG Li, LU Peiquan. Impact of acid reflux event thresholds on the diagnosis and management of oesophageal reflux disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 115-119.
[11] ZHANG Bin, CHEN Sheng, LI Bing, XI Xiaoyu, ZHONG Changqing, GAO Xiaopei, LI Lianyong, SUI Xinke. Analysis of the two-year clinical effectiveness of anti-reflux mucosectomy in 74 patients with laryngopharyngeal reflux [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 120-125.
[12] FAN Yongjiang, HUANG Wei, HE Chengshan, SHEN Haitao, XU Zheng, HAO Yanan. Cytokine expression among patients with acute secretory otitis media after SARS-CoV-2 infection [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(2): 1-6.
[13] WANG Lei, LI Baowei, WANG Gang, LIU Hongdan, HAN Haolun, ZHANG Xiaoli, WU Wei. A preliminary study on nocturnal alkali reflux in OSAHS patients [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 75-79.
[14] SUN Yan, YAO Hao, GU Li'an. Clinical efficacy of intratympanic administration of budesonide combined with ambroxol hydrochloride in the treatment of secretory otitis media in adults [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(6): 77-82.
[15] SHAO Na, ZHANG Qingqing, LIU Xiaohong, XIE Meng, GUO Ruixin, MA Sijing, LIU Haiqin, REN Xiaoyong, LUO Huanan. Effects of Helicobacter pylori infection on salivary pepsin concentration in patients with symptomatic laryngopharyngeal reflux [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(6): 89-95.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!