The Relationship Between Secretory Otitis Media And GERD

Gastro-esophageal reflux disease(GERD)is associated with many symptoms from the respiratory tract,pharyngeal,often asthma symptoms.As gastric acid haven be found in middle ear effusion,it has been suggested GERD might be related to SOM.These observations raise the question whether GERD have a role in secretory otitis media(SOM)and the interactions between them attracted more and more attention.The objectives of this research were to evaluate the incidence of gastro-esophageal reflux disease in SOM patients and none SOM person,classify the relationships between GERD and SOM.Age factors assessment was done to evaluate the relationship of GERD associate SOM with patients age.Little is known about whether GERD is the causes of SOM.we can provide a ground work for a new theory and a strategy to further improve SOM clinical diagnosis and treatment.52 cases(59 ears)of patients with SOM who were outpatient or inpatient in Tianjin First Center Hospital between September 2013 and September 2016 were received.Patients were primary or recurrent SOM with the course of the disease during 2 months to 4 years,except gastrointestinal cancer、gastrointestinal cancer、gastrointestinal cancer 、 large tonsils 、 gastrointestinal malformation 、immunodeficiency 、 cerebral palsy 、 cerebral palsy.During the same period 52 cases healthy subjects without SOM were selected as the normal control group.All cases were underwent otomicroscopic examination,audiological tests and tympanometric tests,24-hour dual-probe pH monitoring or GERD questionnaire or gastroscope examination and clinical symptoms in the diagnosis of GERD.Compare GERD incidences between SOM patients and the normal control group then evaluate their mutual relationship.The pepsin in middle ear effusion was detected by ELISA immunoassay,their concentrations were measured by microplate spectrophotometer.The possible mechanisms of SOM were discussed according to the pepsin in SOM group and the normal control group.In the end,the correlation between SOM and GERD were analyzed according to age.All data were analyzed by SPSS19.0.52 SOM patients were enrolled,35 cases in group SOM detected GERD,the positive rate of GERD was 67.3%;52 cases of the normal control group,6 cases detected GERD,the positive rate of GERD was 11.54%.the positive rate of GERD of SOM group and the control group were compared,and the difference was significant(P<0.05).ELISA and P/N method test showed that pepsin was positive in19 cases of middle ear effusion of 35 cases of GERD patients,the positive rate was54.29%,the pepsin content was 246.6±229.4 ng/mL.1 cases of the pepsin was positive in 17 non-GERD SOM patients,the positive rate was 5.88%,the pepsin content was 195.2 ng/mL.The effusion of pepsin in GERD and non-GERD group were compared,and the difference was significant(x2=11.33,P﹤0.05).To make sure the relationship between SOM and GERD according to age,we found its incidence is increased in youth and old age,school age and in the preschool.The incidence rate is significantly higher in people with SOM than non-SOM people.Therefor,we speculated that the gastro-esophageal reflux disease may be one major cause of the SOM.The samples from middle ear effusions of these patients were pepsin concentrations positively and the positive rate and the absolute value of pepsin is higher in the GERD group,This result gave an idea that the Pepsin could be a major factor in the development and pathology of SOM.This study provides a ground work for a new theory and a strategy to further improve SOM clinical diagnosis and treatment.Age factors influence the incidence GERD related SOM,Which can be speculated that anatomy development and the body’s immune system play a role in SOM pathogenesis.