Transient Inflammation and Dysfunction of the Eustachian Tube Secondary to Multiple Exposures of Simulated Gastroesophageal Refluxant

Heavner, S. Brett; Hardy, Stuart M.; Prazma, Jiri; White, David R.; Pillsbury, Harold C.

doi:10.1177/000348940111001007

Cited by 45 publications

(48 citation statements)

References 16 publications

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“…The correlation between LPR and auricular disorders has been reported by previous studies, even highlighting the presence of pepsin in the middle ear [19][20][21][22][23][24][25][26][27][28]. We are absolutely convinced that this mechanism does exist, to the extent of validating an endoscopic observation characterized by hyperemia of nasopharynx and of tube torus, we have included among the endoscopic signs of LPR's suspicion.…”

Section: Discussionmentioning

confidence: 68%

“…The fullness, already described as a phenomenon deriving from an LPR pathology [19,23], is the expression of the congestion of the Eustachian tube mucosa, followed by the wrong ventilation of the middle ear. The correlation between LPR and auricular disorders has been reported by previous studies, even highlighting the presence of pepsin in the middle ear [19][20][21][22][23][24][25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

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Clinical-Diagnostic Correlations in Laryngopharyngeal Reflux (LPR). The Role of Peptesttm

Gelardi¹,

Eplite²,

Mezzina³

et al. 2017

IJOAOT

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LaryngoPharyngeal Reflux (LPR) is a term recently described, classified among the "extra-esophageal disorders", caused by another pathology called "Gastro-Esophageal Disease" (GED). Pepsin has been recognized as the true marker and the responsible factor of mucosal damage.The clinical-instrumental diagnosis of LPR is mainly based upon video laryngoscopy exam, pH-measuring, pH-impedance measuring, using "score" questionnaires, designed to establish the presence of specific symptoms (Reflux Symptom Index -RSI) and endoscopic signs (Reflux Finding Score -RFS). The evidence of the role of pepsin associated to the LPR helped to develop new technologies, able to detect the presence of that enzyme within the saliva; this device is called Peptest TMThe aim of the present study was to correlate the qualitativequantitative values of salivary pepsin (using Peptest TM ) with symptoms and signs obtained from RSI and RFS. The final goal is to validate this enzyme immunoassay method using LPR diagnostic tools.Seventy-five patients were recruited (41 females, 34 males) aged between 12 and 71 years old, (average age 45 years). All patients performed anamnesis, including food habits analysis, RSI evaluation, rhinofibrolaryngoscopy exam with RFS calculation and Peptest TM.Highly comparable results were obtained in all of the 75 patients undergoing double detection of Peptest TM , with LFD measure (T band intensity) and pepsin concentration (ng/ml).Statistically significant correlation concerning symptoms and saliva pepsin concentration was demonstrated as well as the relationship between objective signs and saliva pepsin concentration. The PeptestTM could become the "Gold standard" in all cases LPR pathology suspicion and may allow revealing the symptoms of that pathology at its early onset, avoiding dealing with more invasive methods and helping to adopt the correct therapeutic follow-up as soon as possible.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Clinical-Diagnostic Correlations in Laryngopharyngeal Reflux (LPR). The Role of Peptesttm

Gelardi¹,

Eplite²,

Mezzina³

et al. 2017

IJOAOT

View full text Add to dashboard Cite

show abstract

“…Heavner et al [4] investigated the effect of LPR on eustachian tube function in rats. The rats in the study group underwent injections of pepsin and hydrochloric acid, and those in the control group underwent injections of saline.…”

Section: Correlation Among Pepsinogen Levels In Middle Ear Fluid and mentioning

confidence: 99%

“…One potential cause of OME is the reflux of gastric contents into the region of the nasopharyngeal mucosa, which initiates an inflammatory process [2] . This pathophysiological mechanism has been frequently questioned in recent studies [3,4,5] . Animal studies have shown that reflux leads to eustachian tube dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Role of Laryngopharyngeal Reflux in the Pathogenesis of Otitis Media with Effusion

Doğru

Kuran²,

Haytoğlu³

et al. 2015

Int Adv Otol

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OBJECTIVE:To determine whether there is an association between otitis media with effusion and laryngopharyngeal reflux in children. MATERIALS and METHODS:This study included 31 children with otitis media with effusion. The pepsinogen level in the middle ear fluid of all patients was measured by sandwich enzyme-linked immunosorbent assay. Each patient's middle ear fluid was investigated for Helicobacter pylori (H. pylori) using the Campylobacter-like organism (CLO) test. The middle ear pepsinogen levels were compared with those in the serum. The correlation between pepsinogen levels and H. pylori positivity in the middle ear fluid was investigated. RESULTS:The mean middle ear pepsinogen level (211.69 ng/mL) was significantly higher than that in the serum (24.18 ng/mL) in patients with otitis media with effusion. The middle ear aspirates of six patients (19%) were positive for H. pylori, and the correlation between H. pylori positivity and increased pepsinogen levels in the middle ear fluid was statistically significant in patients with otitis media with effusion. CONCLUSION:We detected higher pepsinogen levels and H. pylori positivity rates in the middle ear fluid than in the serum of patients with otitis media with effusion. These results support the role of laryngopharyngeal reflux in the pathogenesis of otitis media with effusion.

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“…Once these refl ux events cross a biologic threshold, pathologic changes are produced in the esophagus or upper aerodigestive tract and are termed gastroesophageal refl ux disease (GERD) or extraesophageal refl ux disease (EORD) [9,10,11•]. As otitis media is produced by eustachian tube dysfunction [12,13], EORD is likely to produce infl ammation of the tubal mucosa and surrounding structures of the nasopharynx [12, 14,15]. Alterations in native mucosal defense mechanisms, together with mucosal infl ammation, have been shown to result from refl ux events [16•].…”

Section: Introductionmentioning

confidence: 99%

Gastric pepsin in middle ear fluid of children with otitis media: Clinical implications

He¹,

O’Reilly

Mehta³

2008

Curr Allergy Asthma Rep

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Gastroesophageal reflux and extraesophageal reflux have been postulated to be involved in the pathogenesis of otitis media. This is supported by recent studies revealing the presence of gastric pepsin in the middle ear space of children with otitis media but not in control patients without otitis media. Reflux's role in otitis media appears to be most pronounced in younger children and those with purulent effusions.

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Transient Inflammation and Dysfunction of the Eustachian Tube Secondary to Multiple Exposures of Simulated Gastroesophageal Refluxant

Cited by 45 publications

References 16 publications

Clinical-Diagnostic Correlations in Laryngopharyngeal Reflux (LPR). The Role of Peptesttm

Clinical-Diagnostic Correlations in Laryngopharyngeal Reflux (LPR). The Role of Peptesttm

Role of Laryngopharyngeal Reflux in the Pathogenesis of Otitis Media with Effusion

Gastric pepsin in middle ear fluid of children with otitis media: Clinical implications

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