S117 – Gastropharyngeal Reflux and Eustachian Tube Dysfunction

Abstract

Objectives Determine the response of gastropharyngeal reflux (GPR) in the pathogenesis of Eustachian tube dysfunction (ETD) in adults, using a therapeutic trial. Methods 18 adult outpatients with symptoms of ETD (associated or not to GPR symptoms) were randomized into two groups: The first group received nasal corticosteroids and Rabeprazole 20mg once daily for 6 weeks. The second group received nasal corticosteroids and placebo for 6 weeks. Symptoms’ severity was evaluated before and after treatment by a tympanometry and a self-administered questionnaire of 7 items focusing on the severity of ETD. Each of the items was scored on a numeric scale. The local ethics committee approval was obtained and patients signed an informed consent before their participation in the study that was conducted between November 2002 and May 2003. Results 8 patients were on Rabeprazole, 10 were on placebo. Patients in the 2 groups were comparable for all the variables except for the severity of symptoms. On enrollment, patients under Rabeprazole had more severe symptoms than those under placebo (SR = 12.4, SP = 7.15 with p = 0.035). At the end of the trial, the improvement of the symptom score under Rabeprazole was significantly higher than that of patients under placebo, using the Mann Whitney test (SR’ = 6.13, SP’ = 11.56 with p = 0.026). Conclusions By showing a significant improvement of ETD symptoms in patients under Rabeprazole compared to controls, this study suggests the response of GPR in the pathogenesis of ETD, but larger studies are needed.