[Correlation between adenoid hypertrophy combined with secretory otitis media and laryngopharyngeal reflux in children].

Objective

To investigate the role of laryngopharyngeal reflux （LPR） in children with adenoid hypertrophy （AH） complicated by secretory otitis media （SOM） and to validate the diagnostic accuracy of the Reflux Symptom Index （RSI） and Reflux Finding Score （RFS） against pepsin immunohistochemistry of adenoid tissue.

Methods

Clinical data from 80 children who underwent surgery for AH were analyzed. During surgery, adenoid tissues were stained with pepsin immunohistochemistry. Based on the presence or absence of secretory otitis media, patients were divided into Group A and Group B. Reflux-related indices（RFS, RSI, favorable area ratio, and H-SCORE） were compared between the two groups. The predictive accuracy of RFS and RSI was evaluated according to the results of pepsin staining.

Results

Statistically significant differences in RFS scores（χ²=20.804, P<0.01） and RSI scores（χ²=6.104, P=0.013） were noted between Groups A and B. Using pepsin immunohistochemistry as the reference standard, the sensitivities of RSI, RFS, and the combination of RSI and RFS were 42.42%, 69.70%, and 61.11%, respectively. The corresponding positive predictive values were 50.00%, 67.65%, and 61.11%. This suggests that the validity and diagnostic utility of identifying laryngopharyngeal reflux are enhanced when RFS and RSI are used together. The favorable area ratio of pepsin expression and H-SCORE was significantly greater in Group A compared to Group B, with statistically significant differences observed（P<0.01）.

Conclusion

LPR may be an important pathogenic factor in children with AH plus SOM. Combined use of RSI and RFS provides a simple, office-based tool to identify LPR in this population.