A Little Story about Ear Infections

Ear-Infection-610x406One of the most common complaints that plague early childhood are recurrent ear infections, particularly between the ages of 3 months to 3 years old.1 As well as being extremely painful, they are often accompanied by fever, nausea, vomiting, diarrhea and hearing loss.2 Up to 20% of children will suffer from recurrent infections and the younger the child is when they have their first infection, the more likely it is to reoccur.3

Recurrent ear infections occur when the first infection in the middle ear, either viral or bacterial, isn’t completely resolved, or, put another way, hasn’t drained properly through the ear. This is more common in children for three main reasons:

  1. The angle of the tube that drains the middle ear, the Eustachian tube, is more horizontal due to the size of the child’s face, as opposed to an adult where the tube is more vertical4
  2. The child spends more time lying flat, especially in babies, so gravity can’t assist as much in draining the ear as it would in an adult
  3. Children aren’t generally as good as ‘popping’ their ears as an adult is.

The medical management of recurrent ear infections is, generally, to treat with a course of antibiotics.1 If the infections are recurrent enough to have an impact on the child’s speech and language due to sustained hearing loss, surgical interventions may be considered, commonly known as grommets.

Osteopathic management offers another avenue of treatment, which can be used independently or in conjunction with medication. As the frequent infection suggests poor ability to drain through the middle ear the osteopath with look at the child’s posture, neck movement, surrounding muscle tone and tissue restriction. By gently treating surrounding areas of restriction, the eustachian tube is free to drain the middle ear more efficiently. Treatment is comfortable for the child and, as osteopaths treat the whole body, treatment can also improve the function of the rib cage, neck and shoulders which supports the child’s growth and assists teething problems.

Studies have shown osteopathic management of recurrent ear infections result in a significant decrease in reoccurrence of infection, and subsequently less need for frequent antibiotic use and/or surgery.5,6

References:

  1. Beers, M., Porter, R., Jones, T., et. al., eds., 2006. The merck manual of diagnosis and therapy. Whitehouse Station: Merck Research Laboratories.
  2. Kliegman, R., Stanton, B., Schor, N., St Geme III, J. and Behrman, R., 2011. Nelson textbook of pediatrics. 19th Edition. Philadelphia: Saunders.
  3. Lissauer, R. and Clayden, G., 2012. Illustrated textbook of paediatrics. Fourth Edition. Edinburgh: Mosby Elsevier.
  4. Moore, K.L., Dalley, A.F. and Agur, A.M.R., 2010. Clinically Oriented Anatomy, Sixth Edition.  Baltimore: Lippincott Williams & Wilkins.
  5. Degenhardt BF & Kuchera ML. Osteopathic Evaluation and Manipulative Treatment in Reducing Morbidity of Otitis Media: A Pilot Study. JAOA. 2006 June 106; 6: 327-334.
  6. Mills MV et al. The Use of Osteopathic Manipulative Treatment as Adjuvant Therapy in Children With Recurrent Acute Otitis Media. ARCH PEDIATR ADOLESC MED. 2003 September; 157: 861-866.

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