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Gastroenterology Research and Practice
Volume 2015, Article ID 547959, 5 pages
Clinical Study

Comparison of Three Methods Used in the Diagnosis of Extraesophageal Reflux in Children with Chronic Otitis Media with Effusion

1Department of Otorhinolaryngology, University Hospital Ostrava, 17 Listopadu 1790, 708 52 Ostrava, Czech Republic
2Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic
3Department of Pathology, University Hospital Ostrava, 17 Listopadu 1790, 708 52 Ostrava, Czech Republic
4Gastroenterology Department, Vitkovicka Hospital, Zalužanského 1192/15, 703 84 Ostrava, Czech Republic

Received 16 October 2014; Accepted 23 April 2015

Academic Editor: Greger Lindberg

Copyright © 2015 Martin Formánek et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. Detection of extraesophageal reflux (EER) in children with chronic otitis media with effusion (OME) using three different diagnostic methods. Methods. Children between 1 and 7 years with OME who underwent adenoidectomy and myringotomy with insertion of a ventilation tube were included in this prospective study. EER was detected using three methods: oropharyngeal pH was monitored for 24 hours using the Restech system; detection of pepsin in middle ear fluid obtained during myringotomy was done using Peptest, and detection of pepsin in an adenoid specimen was done immunohistochemically. Results. Altogether 21 children were included in the study. Pathological oropharyngeal pH was confirmed in 13/21 (61.9%) children. Pepsin in the middle ear fluid was present in 5/21 (23.8%) children; these 5 patients were diagnosed with the most severe EER established through monitoring of oropharyngeal pH. No specimen of adenoids tested was positive for pepsin upon immunohistochemical examination. Conclusions. Diagnosis of EER in patients with OME using Restech is sensitive but less specific when compared to the detection of pepsin in middle ear fluid using Peptest. Pepsin in the middle ear was consistently present in patients with RYAN score above 200, and these patients in particular could potentially profit from antireflux therapy.