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Otolaryngol Head Neck Surg ; 136(3): 464-70, 2007 Mar.
Article in English | MEDLINE | ID: mdl-17321879

ABSTRACT

OBJECTIVE: To evaluate if analysis of pepsin/pepsinogen in middle ear effusions can be considered a diagnostic marker for laryngopharyngeal reflux (LPR) in children with otitis media with effusion (OME). MATERIAL AND METHODS: Ambulatory 24-hour dual-probe pH monitoring was carried out on 31 children with OME. Middle ear effusions were collected from 17 children during myringotomy. Total pepsin/pepsinogen concentrations in effusions were measured by ELISA using antipepsin antibody. RESULTS: Dual-probe pH monitoring showed that 22/31 (71%) of the studied children had significant LPR. The concentrations of pepsin/pepsinogen in middle ear effusions, ranged from 0.085 to 5.02 microg/ml, were found to be up to 4.5 to 231.44 times higher than the serum levels. There was a significant positive correlation between the level of pepsin/pepsinogen assayed in the effusions of the 17 children and the number of pharyngeal reflux episodes measured by pH monitoring. CONCLUSIONS: Control of LPR may be an essential component in the successful management of OME in pediatric patients. Pepsin/pepsinogen analysis in effusions of children, using ELISA, can be considered a reliable marker for assessment of reflux in children with OME.


Subject(s)
Gastroesophageal Reflux/diagnosis , Hypopharynx/physiopathology , Otitis Media with Effusion/diagnosis , Pepsin A/analysis , Pepsinogen A/analysis , Adenoidectomy , Biomarkers/analysis , Biomarkers/blood , Child , Child, Preschool , Enzyme-Linked Immunosorbent Assay , Esophageal pH Monitoring , Gastroesophageal Reflux/physiopathology , Humans , Infant , Middle Ear Ventilation , Monitoring, Ambulatory/methods , Otitis Media with Effusion/physiopathology , Pepsin A/blood , Pepsinogen A/blood , Prospective Studies , Tonsillectomy
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