慢性中耳炎症例における上咽頭酸逆流

3チャンネル24時間pHモニタリングによる検討

抄録

Recently, it has been reported that acid reflux might affect the sino-nasal tract and eustachian tube, but no reports are available on the relationship between gastro-esophageal reflux (GERD) and eustachian tube function.
In this study, eustachian tube function (sonotubometry) was measured in 15 patients with chronic otitis media (COM), a GERD questionnaire administered, and pH measurements taken for the lower esophagus, hypopharynx, and nasopharynx were compared with those in 12 control subjects without ear disease to determine whether GERD impairs eustachian tube function.
The incidence of GERD judged by questionnaire was 66.7% in COM and 41.7% in controls, but there was no significant difference. A 24-hour pH monitoring evaluated by time ratio revealed reflux in COM was 33.3% in the lower esophagus, 20% in the hypopharynx. 0% in the nasopharynx, respectively, while that in controls was 25%, 0%, 0%, respectively; no significant difference was observed. On the other hand, the number of subjects with nasopharyngeal reflux events accompanied by a minor pH drop in COM (5 cases) was significantly higher than that in controls (0 cases)(Fisher's exact test, p=0. 0470). However, no correlation was observed between eustachian tube function and nasopharyngeal acid reflux.