Impact of early gastroesophageal reflux disease on childhood otologic outcomes.

OBJECTIVE

Recent evidence has suggested that children with gastroesophageal reflux disease (GERD) face increased risk for otologic disease. This study aims to evaluate otologic outcomes in children with GERD using a large pediatric hearing database.

METHODS

Data pertaining to children with GERD in the first year of life were extracted from the Audiological and Genetic Database. Subgroups included children with uncomplicated GERD, complicated GERD (with esophagitis), and GERD requiring surgery (fundoplication or fundoplasty). Main outcome measures included hearing loss (HL) prevalence, type, severity, and progression. Children without GERD in the first year of life served as controls.

RESULTS

5747 children were diagnosed with GERD in the first year of life. Evidence of HL was present in 40.9% children with uncomplicated GERD, 63.1% in children with complicated GERD, 75% in children with GERD requiring surgical intervention, and 43.3% in controls (p < 0.001). Children with GERD requiring surgery demonstrated the highest odds of developing any HL (aOR 3.02 [1.40-7.26]), moderate-to-profound HL (aOR 3.44 [1.56-7.29]), and mixed HL (aOR 4.58 [2.07-9.65]) relative to children with uncomplicated or complicated GERD. GERD requiring surgery was independently associated with Eustachian tube dysfunction (aOR 2.41 [1.17-5.20]) and tympanostomy tube placement (aOR 6.23 [3.05-13.01]).

CONCLUSION

GERD diagnosed within the first year of life is associated with pediatric hearing impairment and otologic issues, including otitis media, Eustachian tube dysfunction, and need for tympanostomy tube placement. GERD requiring surgical intervention is particularly associated with hearing loss in this population. Children with GERD and HL deserve close audiologic follow-up.