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Pediatric Otolaryngology

(1007) Association Between Gastroesophageal Reflux and Post-Tympanostomy Tube Otorrhea in Children

Saturday, October 17, 2026

Presenting Author(s)

Andrea L. Jakubowski, BS

Medical Student
Lake Erie College of Osteopathic Medicine
Doylestown, Pennsylvania, United States

Co-Author(s)

Leah M. Heiler, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Lancaster, New York, United States
Alicia O. Loui

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, New York, United States
Abraham A. Kassem, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Department of Otolaryngology, Head and Neck Surgery
Buffalo, New York, United States

Senior Author(s)

Michele M. Carr, DDS MD MEd PhD

Professor
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Dept of Otolaryngology
Buffalo, NY, United States

Introduction: Gastroesophageal reflux (GER) may contribute to the development of otitis media in pediatric patients, yet evidence for this relationship is limited. This study examined the association between GER and otorrhea after tympanostomy tube (TT) insertion.

Methods: A retrospective cohort study was conducted using the TriNetX Research Network to identify patients aged 0–18 years who underwent TT placement between 2015 and 2024. Patients were classified based on the presence or absence of a diagnosis of gastroesophageal reflux (GER). Propensity score matching was performed 1:1 based on age, sex, asthma, allergic rhinitis, and chronic sinusitis. Otorrhea occurring from 1 day to 1 year after tympanostomy tube placement was evaluated as the primary outcome. A secondary analysis compared outcomes by GER treatment (famotidine vs omeprazole). Risk ratios, odds ratios, and 95% confidence intervals were calculated.

Results: After propensity score matching, 30,063 patients were included in each cohort (GER vs no GER). The mean age at index was 2.4 years in both cohorts, and approximately 61% of patients were male. Otorrhea was more frequent among children with GER than those without GER (5,428 [17.8%] vs 3,942 [12.9%]; risk ratio [RR] 1.38; 95% CI 1.33–1.43; p < .001).

In a secondary analysis among matched children with GER treated with famotidine or omeprazole (N = 3,097 per group), otorrhea occurred in 554 (17.9%) famotidine-treated patients and 557 (18.0%) omeprazole-treated patients, with no significant difference observed (RR 1.00; 95% CI 0.89–1.11; p = .92).

Conclusions: GER was associated with increased rates of otorrhea following tympanostomy tube placement in children, suggesting reflux management as a modifiable factor in perioperative management.