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. STUDY DESIGN AND SETTING: 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.
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. STUDY DESIGN AND SETTING: 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.