Can laryngopharyngeal reflux initiate middle ear dysfunction?
Reviewed by Madhup K Chaurasia

The prevalence of laryngopharyngeal reflux disorder (LPRD) varies widely and can affect a third of the population, especially in middle ages and, more commonly, females are involved. There is not much in the literature about the association of this condition with middle ear problems. This study included 50 patients (100 ears) diagnosed with laryngopharyngeal reflux disease (LPRD) based on the Reflux Symptom Index (RSI), Reflux Finding Score (RFS) and endoscopy, all of whom had no ear symptoms. Audiometry and tympanometry were performed before and after eight weeks of treatment with pantoprazole and domperidone. Before treatment, most of these patients had hearing thresholds between 25–35 dB. These improved to 20–30 dB. In tympanometry, the number of A-type curves increased from 36 to 74. B-type curves reduced from 56 to 26 and C-type curves reduced by half. The differences were statistically significant. It is speculated that escape of refluxate high up into the nasopharynx can inflame the eustachian tube openings and initiate middle ear dysfunction, possibly leading to retraction pockets and squamo-mucosal disease. The process should therefore be reversed. The message is relevant but screening every LPRD patient for eustachian tube/middle ear dysfunction can remain a far-fetched reality in any practical terms!

Silent middle ear dysfunction due to underlying laryngopharyngeal reflux disease: can it be reversed with anti-reflux therapy?
Chatterji P, Mukherjee Y, Pati S.
J LARYNGOL OTOL
2025;139:856–62.