Another cause of acute otitis media in adults

Background. Acute otitis media (AOM) is much more common in children than in adults. Predisposing factors for the development of AOM are dysfunction of the auditory tube, formations that cause compression of the Eustachian tube or obstruction of its ostium; abnormal immune response. It was also revealed that laryngopharyngeal reflux (LPR) causes a violation of mucociliary transport.

Description of the clinical case. Patient S., 32 years old. She went to the clinic with complaints of pain in the right ear, congestion of the right ear for 1 week, fever up to 37ºС, without a runny nose, but the patient was worried about dripping down the back of the pharynx and sore throat. When searching for the causes of recurrence of AOM in an adult woman, taking into account the results of an objective examination of the ENT organs, there was a suspicion that she had LPR, which was confirmed by the results of the tests. Local treatment with the use of ear drops with lidocaine and phenazone, which stopped otalgia and inflammation due to the analgesic component and anti-inflammatory action, made it possible to avoid the appointment of systemic antibiotic therapy. Antireflux therapy and the elimination of the consequences of nonspecific inflammation of the nasopharyngeal mucosa around the tubal fold made it possible to avoid the recurrence of AOM in a patient suffering from LPR.

Conclusion. Although the exact causal relationship between LPR and AOM is still unclear and new clinical and experimental studies are needed to study it in both children and adults taking into account acid, weak acid and alkaline refluxes, this cause of eustachian tube dysfunction must be taken into account in adult patients.