Association of Laryngopharyngeal Reflux and Otitis Media with Effusion in adults – A Cross-Sectional Study
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Abstract
Background: Otitis media with effusion (OME) in adults is less common than in children but may be underdiagnosed, particularly when secondary to laryngopharyngeal reflux disease (LPRD). Reflux-induced nasopharyngeal inflammation can impair Eustachian tube function, potentially contributing to OME.
Aim: To evaluate the association between LPRD and OME in adults attending an ENT outpatient clinic.
Methods: This cross-sectional study was conducted over six months period in a tertiary care hospital, Chengalpattu to assess OME in 100 adults (≥18 years) presenting with throat-related complaints. OME was diagnosed by otoscopic and tympanometric criteria. LPRD was assessed using the Reflux Symptom Index (RSI) and Reflux Finding Score (RFS), with cut-offs of ≥13 and ≥7, respectively. Statistical analyses included chi-square test, independent t-test, Pearson correlation, and multivariate logistic regression.
Results: OME was detected in 28% of participants (n=28), with 64.3% (n=18) unilateral and 35.7% (n=10) bilateral disease. Mean RSI (18.4 ± 4.6) and RFS (9.2 ± 2.1) were significantly higher in OME patients than in non-OME participants (p < 0.001). Among patients with RSI cut-off ≥13, the frequency of LPRD positivity was significantly higher among OME patients (92.9%, n=26) compared to non-OME patients (56.9%, n=41) (p < 0.001). RSI and RFS showed a moderate positive correlation (r = 0.56, p < 0.001). Logistic regression identified RSI ≥13 (OR 3.80; 95% CI 1.43–10.07; p = 0.008) and RFS ≥7 (OR 2.90; 95% CI 1.17–7.20; p = 0.015) as independent predictors of OME.
Conclusion: LPRD is significantly associated with OME in adults, with elevated RSI and RFS serving as independent predictors.