title: Gastric reflux is uncommon in acute post-tympanostomy otorrhea.
abstract: OBJECTIVE
  Acute post-tympanostomy otorrhea (APTO) is a common complication of tympanostomy tube placement. APTO has been related primarily to viral upper respiratory infections and external ear contamination. Elevated levels of gastric enzymes have been found in a large proportion of chronic middle ear effusions, implicating gastric reflux (GR) in its pathogenesis. Thus, our objective was to determine whether GR may be a contributing factor in the development of APTO.
  
  
  METHODS
  Prospective, nonrandomized design. Otorrhea samples were collected from children with APTO. Total pepsinogen concentrations were measured with a commercial ELISA, using a pepsinogen I-specific capture antibody and horseradish peroxidase detection antibody.
  
  
  RESULTS
  Twenty-six samples from 24 patients were collected and analyzed. Eight samples demonstrated measurable pepsinogen I, but the measured concentrations, 2-17 mg/L, were below the normal serum reference ranges.
  
  
  CONCLUSIONS
  GR does not play a major role in the development of APTO in children.
authors.affiliation: University of Florida, Department of Otolaryngology, Gainesville, FL 32610-0264, USA. antopj@ent.ufl.edu
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Antonelli
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Lloyd
authors.forename: James C
authors.initials: JC
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D015984:Causality; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation; D010033:Otitis Media / Q000453:epidemiology / Q000601:surgery*; D010034:Otitis Media with Effusion / Q000453:epidemiology / Q000601:surgery*; D020116:Pepsinogen A / Q000032:analysis*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012141:Respiratory Tract Infections / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors; D014777:Virus Diseases / Q000150:complications / Q000175:diagnosis
chemical_list: D020116:Pepsinogen A