Chiropractic: Physicians Plus

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CONDITIONS AND CONCERNS

Ear Infections

Most commonly due to a malfunctioning of the Eustachian tube, the ear canal becomes plugged, usually the result of a viral upper respiratory infection, allowing fluid to accumulate in the middle-ear space. This serves as a nutrient for bacteria to grow.

The infected fluid results in pulling at the ear, crankiness, ear pain, fever, and decreased appetite. Under most circumstances, the parent consults with their pediatrician and given the recommended antibiotic. Over the next ten days, the idea is to kill the bacteria and prevent additional fluid buildup; otherwise the ear infection may recur and require a whole new course of treatment. Pain may last several days and fever may take its course through the same. The question here is, what is the role of antibiotics for ear infections when a significant percentage of otitis media cases that are not even caused by bacteria,^1,2 but presumably by either viruses or sterile effusions, neither of which would be expected to ever respond to antibiotics?

When the condition is at its worst, and only when absolutely necessary, tubes are placed through the eardrum. For recurrent otitis media, recommend daily dose of antibiotics ensues. It is said that by age's four to five, the frequency of ear infections usually decreases significantly as a child's Eustachian tubes become a little wider, more curved, and better able to drain fluid from the middle ear. ^3.

Apparently, most pediatricians are not reading their own medical literature. In 1974, following a study done on about 3,000 children, the following results appeared: 88 percent of all patients with acute otitis media never need antibiotics. When antibiotics are begun on the first day of the disease, the frequency of recurrence is 2.9 times higher than when no antibiotics are used. When antibiotics are begun on the eighth day, the rate of recurrence is 1.3 times higher. Antibiotic therapy does not shorten the disease by any standard. Otitis media is caused by one or all of the following: Allergy (change the milk), infection, mechanical obstruction, and nutritional deficiency. Tubes produce temporary improvement in hearing, but there is no difference in a few months if tubes are used or not; those with tubes are more likely to develop scarring or a permanent perforation. (A well-documented book called Childhood Ear Inections written by Dr. Michael Schmidt, North Atlantic Books, Berkeley, reveals all the current research that most pediatricians have not followed.)

"I could almost cry that not a word was mentioned about the importance of breast feeding and about building up the immune system with vitamin C, zinc, essential fatty acids, and time. Are all these doctors tools of the pharmaceutical industry? Shame." ⁴

Because of the close anatomical and embryological relationship between the TMJ and the middle ear, there also exists the possibility that a dysfunctioning temporomandibular joint (TMJ) may initiate the bout of otitis media, primarily by its relationship to the tensor veli palatini muscle. This muscle controls the function of the eustachian tube. Improving the function of the eustachian tube by altering the relationship between the TMJ and the muscles of mastication (used to chew), similar to the way we treat craniomandibular (TMJ) dysfunction in adults, may decrease the incidence as well.⁵

A 1996 study, published in the Journal of Manipulative and Physiological Therapeutics, indicated that limitation of medical intervention and the addition of chiropractic care may decrease the symptoms of ear infection in young children.⁶ The study found a 93% rate of improvement in cases of childhood ear infection/discomfort as a result of chiropractic care. The study also determined a patient's having no history of antibiotic use was a factor associated with improvement with the fewest number of treatments. In other words, those patients who had not previously used antibiotics required fewer treatments to relieve their symptoms.

A 1997 study published by the Journal of Chiropractic Pediatrics concluded that, "There is a strong correlation between the chiropractic adjustment and the resolution of otitis media for the children in this study."⁷

Del Mar C, Glasziou P, Hayem M. Are antibiotics indicated as initial treatment for chidren with acute otitis media? A meta-analysis. British Medical Journal 1997; 314: 1526-1529.
Pitkaranta A, Jero J, Arruda E, Virolainen A, Hayden FG. Polymerase chain reaction-based detection of minovirus, respiratory syncytial virus and coronavirus infection in otitis media with effusion. Journal of Pediatrics 133(3): 390-394.
American Academy of Pediatrics (AAP). Shelov, M.D., F.A.A.P., professor of Pediatrics, director of Pediatric Education at the Albert Einstein College of Medicine, New York.
Lendon H. Smith, M.D. Portland, Oregon. Who's in Charge Here? Chiroweb.
Youniss S. The relationship between craniomandibular disorders and otitis media in children. Cranio. 1991 Apr;9(2):169-73.
Froehle RM. Ear infection: A retrospective study examining improvement from chiropractic care and analyzing for influencing factors. Journal of Manipulative and Physiological Therapeutics 1996; 19(3): 169-177.
7 Fallon J. The role of chiropractic adjustment in the care and treatment of 332 children with otitis media. Journal of Clinical Chiropractic Pediatrics 1997; 2(2): 167-183.