Clinical Trials Logo

Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02183961
Other study ID # FNO-ENT-EER Peptest Restech
Secondary ID
Status Completed
Phase N/A
First received July 2, 2014
Last updated July 2, 2014
Start date June 2012
Est. completion date May 2014

Study information

Verified date July 2014
Source University Hospital Ostrava
Contact n/a
Is FDA regulated No
Health authority Czech Republic: Ethics Committee
Study type Interventional

Clinical Trial Summary

Detection of extraesophageal reflux (EER) in children with chronic otitis media with effusion (OME) using three different diagnostic methods and selection of the group of patients with severe EER who could potentially benefit from antireflux therapy.


Description:

Children aged between 1 and 7 years diagnosed with bilateral or unilateral OME who underwent adenoidectomy and myringotomy with insertion of a ventilation tube were included in the prospective study. OME was defined as effusion in the middle ear behind an intact eardrum for longer than 3 months. Diagnosis was made on the basis of otomicroscopic findings, pneumatic otoscopy, type B tympanometry and audiometry (in older, cooperative children). Children with no fluid in the middle ear during myringotomy were re-diagnosed as having tympanosclerosis and were excluded from the study. Children with craniofacial abnormalities (Down syndrome, Treacher Collins syndrome, clefts etc.) were excluded from the study as well. Demographic data and symptoms of EER disease were provided by parents, who were specifically asked about hoarseness, recurrent lower respiratory infections (bronchitis, pneumonia) and bronchial asthma in their child.

24 hour monitoring of oropharyngeal pH using the Restech system was performed before surgery. Parents were instructed to record the time their child spent eating, drinking and in a horizontal position directly to the device and manually to the diary. If there was any discrepancy, periods logged in the device were modified according to the diary. A standardized RYAN composite score was calculated automatically using the software supplied. Patients with pathological RYAN composite scores in the vertical (higher than 9.4) and/or horizontal (higher than 6.8) position were classified as having pathological EER. Severe EER was diagnosed when the RYAN composite score in the vertical or horizontal position was higher than 200.

Myringotomy using a microscope was done on the anterior inferior part of the tympanic membrane. The type of middle ear effusion (fluid, mucous) was registered. Middle ear fluid was collected using a special suction device with a collecting bottle, and a ventilation tube was inserted in the tympanic membrane. In the case of bilateral OME, middle ear fluids were collected and analysed separately. The specimen was first standardized. 0.1 ml of 10% citric acid was added, the specimen was centrifuged for 10 minutes and subsequently the original migration reagent was added. Afterwards, the specimen was examined using Peptest, which contains monoclonal antibodies that target pepsin. The result of the Peptest was given as positive (2 lines), negative (1 line) or invalid (no line).

Then, adenoidectomy using a cold instrument was performed. A specimen of adenoids (5x5x5mm) from the area close to the torus tubarius was fixed in formaldehyde and immunohistochemically analysed at the Department of Pathology. Antibody P3635Rb-h (Uscnlife, USA, concentration 1:100) was used as the primary antibody. Antibody N-HistofineSimple Stain MAX PO (Nichirei Biosciences Inc.) was used as the secondary antibody.

Statistical analysis was done using MS Excel.


Recruitment information / eligibility

Status Completed
Enrollment 24
Est. completion date May 2014
Est. primary completion date March 2014
Accepts healthy volunteers No
Gender Both
Age group 1 Year to 7 Years
Eligibility Inclusion Criteria:

- children with otitis media with effusion

- age 1-7 years

- signing of the informed consent

Exclusion Criteria:

- children with craniofacial abnormalities (Down syndrome, Treacher Collins syndrome, clefts etc.)

Study Design

Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic


Intervention

Other:
Restech

Peptest

Detection of pepsin in adenoid specimen


Locations

Country Name City State
Czech Republic University Hospital Ostrava Ostrava Moravian-Silesian Region

Sponsors (1)

Lead Sponsor Collaborator
University Hospital Ostrava

Country where clinical trial is conducted

Czech Republic, 

References & Publications (4)

Jiang A, Liang M, Su Z, Chai L, Lei W, Wang Z, Wang A, Wen W, Chen M. Immunohistochemical detection of pepsin in laryngeal mucosa for diagnosing laryngopharyngeal reflux. Laryngoscope. 2011 Jul;121(7):1426-30. doi: 10.1002/lary.21809. Epub 2011 Jun 6. — View Citation

O'Reilly RC, He Z, Bloedon E, Papsin B, Lundy L, Bolling L, Soundar S, Cook S, Reilly JS, Schmidt R, Deutsch ES, Barth P, Mehta DI. The role of extraesophageal reflux in otitis media in infants and children. Laryngoscope. 2008 Jul;118(7 Part 2 Suppl 116):1-9. doi: 10.1097/MLG.0b013e31817924a3. — View Citation

Wiener GJ, Tsukashima R, Kelly C, Wolf E, Schmeltzer M, Bankert C, Fisk L, Vaezi M. Oropharyngeal pH monitoring for the detection of liquid and aerosolized supraesophageal gastric reflux. J Voice. 2009 Jul;23(4):498-504. doi: 10.1016/j.jvoice.2007.12.005. Epub 2008 May 12. — View Citation

Zeleník K, MatouĊĦek P, Urban O, Schwarz P, Stárek I, Komínek P. Globus pharyngeus and extraesophageal reflux: simultaneous pH <4.0 and pH <5.0 analysis. Laryngoscope. 2010 Nov;120(11):2160-4. doi: 10.1002/lary.21147. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary The frequency of the extraesophageal reflux in children with otitis media with effusion measured with three different methods Children between 1 to 7 years diagnosed with OME who underwent adenoidectomy and myringotomy with insertion of a ventilation tube were included in this prospective study. EER was detected using three methods: oropharyngeal pH was monitored for 24 hours using the Restech system; detection of pepsin in middle ear fluid obtained during myringotomy was done using Peptest, and detection of pepsin in an adenoid specimen was done immunohistochemically using antibody P3635Rb-h. 2 years No
See also
  Status Clinical Trial Phase
Completed NCT03590912 - Efficacy and Cost Analysis of Steroids in Treatment of Otitis Media With Effusion Phase 4
Completed NCT03611842 - Study of the Expression of MMPs in OME in Children With Atrophy of the Eardrum
Not yet recruiting NCT01421199 - Device Study to Evaluate the Detection and Characterization of Middle Ear Fluid in Children N/A
Completed NCT01202578 - Evaluation of the Tympanostomy Tube Delivery System Phase 2/Phase 3
Completed NCT00629694 - Adenoidectomy, Myringotomy and Tubes' Insertion vs Adenoidectomy and Myringotomy Alone in Children With Otitis Media With Effusion and Adenoid Hypertrophy Phase 2
Completed NCT00520039 - Osteopathic Otitis Media Research Study N/A
Completed NCT00195611 - Study of Streptococcus Pneumoniae in Nose and Throats of Infants With Acute Otitis Media Phase 4
Not yet recruiting NCT05402267 - The Effects of Exosomes in Otitis Media With Effusion
Not yet recruiting NCT04584073 - Secretory Otitis Media in Adenoids Hypertrophy Patients N/A
Withdrawn NCT00736112 - Food Allergy - Tubes - Adenoids (FATA) Trial N/A
Completed NCT00546117 - A Clinical Trial of Proton Pump Inhibitors to Treat Children With Chronic Otitis Media With Effusion N/A
Withdrawn NCT02950311 - Xylitol for Otitis Media Phase 2/Phase 3
Recruiting NCT05324696 - Autoinflation: Alternative in the Treatment of Otitis Media With Effusion N/A
Recruiting NCT05353569 - Coherent Optical Detection of Middle Ear Disease N/A
Completed NCT02282540 - Novel Imaging of the Eustachian Tube; Patient Study N/A
Not yet recruiting NCT03491098 - The Efficacy of Nasal Steroids in Treatment of Otitis Media With Effusion: Acomparative Study Early Phase 1
Completed NCT01082029 - Study of Anti-reflux Medication as a Potential Treatment for Glue Ear in Children Phase 4
Completed NCT00939796 - Clinical Study of the Tympanostomy Tube Delivery System N/A
Recruiting NCT06316635 - Microplastics in Otitis Media With Effusion Material
Recruiting NCT02215681 - Acupuncture Effect on Inflammatory Markers in Pediatric Otitis Media With Effusion: A Pilot Study N/A