Effects of trypsin and pepsin detection on chronic otitis media with effusion

Zeqi Zhao; Zhengzhong Han; Yudi Shao; Tingting Tang; Caiji Wang; Bing Xu; Zhenlu Zhao; Xi Shi; Dan Jin; Wei Li

doi:10.1016/j.heliyon.2024.e40112

Effects of trypsin and pepsin detection on chronic otitis media with effusion

Heliyon. 2024 Nov 5;10(21):e40112. doi: 10.1016/j.heliyon.2024.e40112. eCollection 2024 Nov 15.

Authors

Zeqi Zhao^{1

2}, Zhengzhong Han³, Yudi Shao^{1

2}, Tingting Tang^{1

2}, Caiji Wang^{1

4}, Bing Xu^{1

4}, Zhenlu Zhao⁵, Xi Shi^{6

7}, Dan Jin^{1

2}, Wei Li^{1

2}

Affiliations

¹ Department of Otorhinolaryngology-Head and Neck Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, China.
² Artificial Auditory Laboratory of Jiangsu Province, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, China.
³ Department of Neurosurgery, Xuzhou Children's Hospital, Xuzhou, Jiangsu Province, 221002, China.
⁴ Institute of Audiology and Balance Science, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, China.
⁵ Department of Otorhinolaryngology-Head and Neck Surgery, Xuzhou Children's Hospital, Xuzhou, Jiangsu Province, 221002, China.
⁶ Key Laboratory of Tropical Biological Resources of Ministry of Education, School of Pharmaceutical Sciences, Hainan University, Haikou, Hainan, 570228, China.
⁷ Song Li's Academician Workstation of Hainan University, School of Pharmaceutical Sciences, Haikou, Hainan, 570228, China.

Abstract

Chronic otitis media with effusion (COME) is a common cause of hearing loss in children and adults. Laryngopharyngeal reflux (LPR) is often overlooked in the clinical management of COME complicated by LPR. This study aimed to investigate the presence and concentration of trypsin and pepsin in the middle ear effusion (MEE), as well as the recurrence rate of otitis media with effusion (OME) in COME patients with trypsin-/pepsin-positive MEE after acid-suppressive treatment (AST). In this study, trypsin and pepsin were found in the MEE of COME patients. Follow-up results showed that the recurrence rate of OME within 1 year was significantly lower in the AST group than in the non-AST group. Taken together, patients with COME can be offered pepsin detection of MEE, and if the pepsin test is positive, acid-suppressing drugs such as proton pump inhibitors could be recommended to prevent the recurrence of OME.

Keywords: Chronic otitis media with effusion; Laryngopharyngeal reflux; Pepsin; Trypsin.