Detecting Reflux in Adults with Eustachian Tube Dysfunction

Abstract

Objective: 1) Ascertain whether adult patients with Eustachian tube dysfunction (ETD) have a higher incidence of reflux into the nasopharynx compared with controls. 2) Utilize recent advances in pH probe technology to detect acidity at the Eustachian tube orifice for direct comparison. Method: A prospective study was performed on 38 adult patients in an outpatient setting between November 2009 and February 2011. Seventeen patients with Eustachian tube dysfunction and 21 control subjects had a Dx-pH probe (Restech, San Diego, California 2006) placed near the torus tubarius in the posterior nasopharynx for 24 hours. Results: The average pH value obtained from the nasopharynx of adults with no history of ETD was 7.03 (range, 6.10-7.92; SD, 0.69). In comparison, the average pH for patients with ETD was 6.90 (range, 5.33-8.06; SD, 0.77). This P value for this difference was .48. The average number of reflux events for subjects was 0.55 events over a 24-hour period for controls and 2.1 for patients with ETD. Decreases in pH were considered reflux events if the pH dropped below 5.5 while in the upright position or below 5.0 in the supine position. Conclusion: By utilizing a novel pH probe that allows detection of acidity in a non-liquid environment, a comparison of nasopharyngeal pH between control patients and those with ETD was performed. A trend toward higher numbers of reflux events was found in patients with ETD when compared to control subjects.