Charakterystyka refluksu krtaniowo-gardłowego oraz żoł&acedil;dkowo-przełykowego u dzieci z wysi&ecedil;kowym zapaleniem ucha środkowego

Jastrz&ecedil;bska, Izabela; Górecka-Tuteja, Anna; Sładek, Małgorzata; Składzień, Jacek; Fijorek, Kamil; Fyderek, Krzysztof
August 2012
Contemporary Pediatrics, Gastroenterology, Hepatology & Child Fe;2012, Vol. 14 Issue 2, p69
Academic Journal
Introduction: Laryngopharyngeal reflux can damage the mucous membrane of the upper respiratory tract, among others of the Eustachian tube. Tubotympanal disorders are the basic etiologie factor of otitis media with effusion (OME), which is the main cause of the acquired hearing loss in children. Aim of the study: The aim of the study was to assess the presence of the laryngopharyngeal reflux (LPR) as well as of the gastroesophageal reflux (GER) in children with otitis media with effusion (OME). Material and methods: We included into the prospective study 21 children with otitis media with effusion, diagnosed on the basis of otomicroscopic examination, tympanometry and audiometry. A 24-hour multichannel intraluminal impedance (Mil) combined with dual pH-metry with the use of laryngological electrode was performed in all the patients. Proximal pH probe was positioned 1 cm above the upper esophageal sphincter; distal pH probe was situ-ated 3-5 cm above the lower esophageal sphincter. Pathologic GER was diagnosed on the basis of the Mil. LPR episode was defined as at least one episode of reflux in the proximal channel of Mil combined with pH drop < 5.0 in the prox-imal pH probe. Results: The mean age of the patients was 7 years (range 6-10). 71 % of them were males. 7 patients had unilateral and 14 had bilateral OME. Mean cochlear reserve was 26.2 dB in the right ear and 25.8 dB in the left ear. There were 19 patients with tympanograms type B and 2 with type C. Pathologic GER was diagnosed in 10 patients (acid GER in 8 and non-acid GER in 2). LPR was found in 16 patients. In total, there were 50 episodes of LPR, the mean number of LPR episodes per one patient amounted to 3.13. Most of them were liquid - 27 (54%) and most frequently the LPR episodes were present in the upright position. Conclusion: Pathologic GER and LPR observed in patients with OME may be an important risk factor of this disorder.


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