The prevalence of gastroesophageal reflux disease in children with chronic otitis media with effusion/recurrent acute otitis media may be higher than the overall prevalence for children. Presence of pepsin/pepsinogen in the middle ear could be related to physiologic reflux. A cause-effect relationship between pepsin/pepsinogen in the middle ear and otitis media is unclear. Antireflux therapy for otitis media cannot be endorsed based on existing research.
The novel findings of this study are lower rates of airway intervention than reported previously and the fact that multiple affected sites were associated with admission and intubation or tracheostomy, particularly when the edema involved the larynx or hypopharynx.
Angioedema—nonpitting edema of the mucous membranes and skin—most commonly occurs
as a complication from the use of angiotensin-converting enzyme inhibitors. At
our institution, the otolaryngology department has incorporated the use of the
endotracheal tube cuff-leak test and bedside direct laryngoscopy to aid in
timing for extubation of angioedema patients. Prospective data collection of
patients presenting to the emergency department with angioedema was performed.
Of 76 patients with angioedema, 9 required fiberoptic intubation. Intubation was
performed at a median of 73 hours (range, 44-118). An endotracheal tube
cuff-leak test was performed in 7 patients prior to extubation, and bedside
direct laryngoscopy was also performed in 3 of these 7 patients to document
resolution of laryngeal edema. The use of the endotracheal tube cuff-leak test
and bedside direct laryngoscopy is an easy and inexpensive method to help
determine eligibility for extubation in patients intubated for angioedema.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.