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Osteopathic Manipulative Medicine in the Treatment of Acute Otitis Media Symptoms

Journal: The Journal of the American Osteopathic Association Date: 2008/08, 108(8):Pages: 416. doi: Subito , type of study: randomized controlled trial

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2008.108.8.413/html)

Keywords:

children [292]
counterstrain [53]
otitis media [36]
pediatrics [515]
randomized controlled trial [880]

Abstract:

Hypothesis: It is generally accepted that a primary cause of Otitis Media is dysfunction of the eustachian canal, with an effusion. The eustachian canal is lined with respiratory mucosa, and directly connects the middle ear to the nasopharynx. The intimate relationship between myofascial structures has already been demonstrated. It has been postulated that fascia not only surrounds, but also interacts with and impacts, every structure within the body, including the eustachian canal. Ergo, by treating this fascia, we will also impact the eustachian canal, ideally optimizing its function in reducing pressure in the middle ear, and improve the functioning of the tympanic membrane. Materials: We incorporated the use of tympanograms to measure middle ear parameters, as well as a pain visual-analog scale and a survey to gather pertinent past medical history. Methods: After gaining IRB approval, we enrolled 10 patients between the ages of 3 and 12, and randomly assigned them to either the treatment or the sham group. After obtaining parental consent, we gathered data prior to treatment and five minutes following treatment via the surveys and the tympanogram. The treatment consisted of a strain-counter-strain technique directed at a tenderpoint over the OA for 90 seconds. The sham treatment consisted of placement of fingers around the ear, and holding for 90 seconds. Results: The data shows a very strong correlation between patients having a diagnosis of acute otitis media and the presence of a tenderpoint at the OA, ipsilateral to the affected ear. The active group demonstrated resolution of this tenderpoint, while the control group showed no change. Furthermore, patients in the treatment group demonstrated an increase in their maximum tympanic membrane compliance, (t, p<0.03), indicating improved tympanic membrane function. The treatment group also showed significant changes, indicating a decrease in middle ear pressure within five minutes following treatment, (t, p<0.05). This change is consistent with the drainage of the middle ear through the now patent eustachian canal. Conclusion: This study illustrates a strong correlation between strain-counter strain treatment of an OA tenderpoint in pediatric patients with acute otitis media, and the improvement in drainage from the middle ear via the eustachian canal. A decrease in middle ear pressure was also demonstrated in the treatment group, which is consistent with improved eustachian canal function.


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