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Glue Ear & Cranial Osteopathy

(Otitis Media with Effusion (OME))

OTITIS MEDIA:  Try osteopathy before grommets

Acute otitis media is a painful and nasty disease of the middle ear in children, which doctors usually treat with courses of antibiotics.

Unfortunately, this often offers only a short-lived reprieve, if any, and the child may sometimes have to undergo surgery to have grommets inserted if the problem keeps recurring.

This is traumatic for the child and parents, so both will be interested in a study that discovered osteopathy offers a long-term solution.

Children who had three or four episodes of otitis media in the previous year were either assigned to routine care (mainly antibiotics) or to routine care plus osteopathy.  

Those in the osteopathy group needed less medical care and suffered fewer attacks than those just receiving standard treatment.

(Source: Archives of Pediatrics & Adolescent Medicine, 2003; 157: 861-66).

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Glue Ear

Otitis Media with Effusion (the fluid or 'glue'), commonly known as glue ear is a build up of secretions in the middle ear, behind the eardrum. The increasing pressure causes great discomfort and distress to the child, and parents. If left to persist the ear may become infected, increasing the risk of deafness and worse.

Most commonly occurring in infants, but it can drag on to even adult hood. The orthodox medical approach at present is to watch and wait for 6 months, as many do resolve without help. Prescribe antibiotics if infection sets in and consider the insertion of grommets. Grommets are tiny tubes that are inserted through the eardrum to provide a drainage hole. This however does involve perforating the eardrum, which inevitably leads to scarring and the possibility of a degree of deafness. A variety of other approaches may be tried, such as antihistamines, removal of the adenoids, etc., but none with any great success as, from an osteopathic point of view these approaches only try to deal with the symptoms and do not actually addresses the underlying cause. It is generally agreed that the cause is poor drainage from the middle ear. This is not helped by the angle of the eustation tube in the early years.

A further issue with this condition is the common, accompanying deafness, when the child is at such a critical stage of developing language skills.

More recently scientists have discovered that in some cases a protein is present that is normally found in the stomach. This is thought to stimulate the secretory cells into producing too much mucous. Even in these cases it's easy to see that improved drainage will help the matter.

The point of contention lies in the existence of movement and motility of the cranial bones, that assists the drainage and is a normal function of health generally. This is referred to as the Cranio-Sacral mechanism or involuntary movement system. The first term given here is rather misleading, as this movement pattern exists throughout the body and the name refers to the areas of the body (skull & sacrum) that this motion was first observed and these are particularly key areas. These movement patterns are very gentle and subtle, and are not readily felt by the untrained hand. They have been there since day one, so we are not normally aware of them.

To use the example of glue ear, it is often found that the temporal bone that houses the ear hole (auditory canal) is jammed or its? mobility is compromised in some way. For effective drainage to occur this and any adjacent cranial bones need to be released to move freely. The treatment approach is very gentle and non-invasive, and quite often have an immediate calming effect on the child.

Considered causes, would include:-

A particularly difficult delivery involving excessive compression of the skull in the birth canal. (Breech, emergency caesarean (due to being stuck in birth canal, etc.)

The use of forceps or ventouse cup, often resulting in the ?cone head? appearance of the skull.

Equally in a particularly rapid birth or caesarean, where the skull has not been through the natural moulding process.

Other problems that may be due to the above scenarios would include, colic, general irritability & distress, feeding difficulties, etc.

The osteopathic approach to the treatment of children with glue ear has been widely studied, but still not generally accepted by conventional medicine. One research paper by an Italian osteopath and was published in The Osteopath (Feb., 2001). The study was carried out on a small number (18) of 'no hopers' i.e. the condition was long standing and they had all been subjected to a variety of surgical procedures and drugs, already. Assessment before & after was by a whole battery of tests including direct observation of ear drum and various hearing tests. All the before & after scores were added (50 ? being full health) resulting in an average of 13.1 (26.2%) before treatment and ending in an average of 39.7 (79.4%) after treatment. And -

'A clear improvement in otoscopic examination results was achieved in 100%.'

The study concludes with: However, based on the results of this study, compared to conventional medical therapy, osteopathy ensures the following benefits: no drug related side effect, no invasive treatment (no ventilation tube (grommet) and myringocentesis), no anaesthesiological (anaesthetic) risk, general well-being, remission of secondary, possible remission of the original pathological process, decrease in health care costs?

Final Note about Cranial Osteopathy & Glue Ear

I am particularly interested in treating children with this condition and a few years ago I was having discussions with a local paediatrician in view of researching the effectiveness of the osteopathic approach with 'glue ear'. Sadly this hasn't happened yet, but one day, maybe.

It's worth noting that the use of grommets for glue ear has fallen out of fashion of late, with it only being used in the more severe cases. We have seen this before with standard medical procedures falling out of fashion due to lack of effectiveness &/or a lack of supporting research. More importantly from an osteopathic point of view -

It simply doesn't address the underlying problem!

There was a BBC documentary recently that seemed to be attributing glue ear to the child's parents smoking. Certainly there is evidence that shows that it's a contributing factor, but it's just one contributing factor and not a single cause. All this demonastrates is that they are hypersensitive to cigarrette smoke and if they have one hypersensitivity, then they probably have more. But the immediate problem is poor drainage from the middle ear, which can usually be improved with a few treatments of cranial osteopathy.

I find few things more satisfying than assisting in the balance of health in the young and therefore giving them the best possible opportunity for the future. They are so adaptable and open to change that a few treatments is often all that is required (if caught early), with parents gratefully receiving the transformation of an inconsolable screaming child to the little angel they had hoped for.