A prospective study of the effect of gastroesophageal reflux disease treatment on children with otitis media.
OBJECTIVE
To demonstrate improvements in validated quality-of-life measures for otitis media and gastroesophageal reflux disease (GERD) and an objective score for pediatric reflux obtained by fiberoptic laryngoscopy after treatment with antireflux precautions and therapy in children diagnosed as having either recurrent acute otitis media or otitis media with effusion and GERD.


METHODS
Prospective, before-and-after intervention study.


METHODS
Hospital-based pediatric otolaryngology practice.


METHODS
Population-based sample of 47 patients (mean age, 19.5 months).


METHODS
Standard antireflux therapy for 2 consecutive 12-week periods.


METHODS
Otitis Media 6-Item quality-of-life survey, Infant GERD Questionnaire-Revised, GERD Symptom Questionnaire for Young Children, Pediatric Reflux Finding Score, and speech awareness threshold.


RESULTS
Follow-up data were available for 37 patients. Mean (SD) change scores for Otitis Media 6-Item quality-of-life survey were 1.6 (1.1) at visit 2 and 1.5 (1.1) at visit 3 (P < .001 and P = .004, respectively). Change scores were significantly improved for Infant GERD Questionnaire-Revised and GERD Symptom Questionnaire for Young Children at visit 2 and for Infant GERD Questionnaire-Revised at visit 3. Mean (SD) change scores for the Pediatric Reflux Finding Score were 6.4 (4.9) at visit 2 and 8.0 (7.2) at visit 3 (P < .001 and P = .03, respectively). Hearing loss was significantly improved following therapy, as were laryngeal findings of reflux on fiberoptic laryngoscopy. Otitis media was considered by the examining physician to be clinically improved in 28 of 37 children (76%; 95% confidence interval, 60%-87%) at visit 2 and in 6 of 10 children (60%; 95% confidence interval, 31%-83%) at visit 3. Nine children (19.1%) required myringotomy tube placement.


CONCLUSIONS
Children with otitis media with effusion or recurrent acute otitis media and GERD have improved quality of life following treatment with antireflux therapy. Control of gastroesophageal reflux may play a role in the management of otitis media and avoidance of tympanostomy.
Department of Otolaryngology, State University of New York-Downstate Medical Center, Brooklyn, NY 11203, USA.
Edward D
ED
McCoul
Nira A
NA
Goldstein
Bernard
B
Koliskor
Jeremy
J
Weedon
Alison
A
Jackson
Ari J
AJ
Goldsmith
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001299:Audiometry / Q000379:methods; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D010033:Otitis Media / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D010034:Otitis Media with Effusion / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D011788:Quality of Life; D012008:Recurrence; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods
D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors