Clinical Chiropractic 2004 (Dec); 7 (4): 168–173
10 Astwood Mews, London SW7 4DE, UK
Objective: Comparison of the risk factors identified in one patient and the outcome of treatment, with the epidemiological risk factors identified in the literature that predispose to otitis media with effusion that can potentially influence the outcome of chiropractic treatment. The aim of this case study is to focus practitioners when taking a case history, in order to aid an individual prognosis and treatment plan for each patient.
Clinical features: A 31/2-year-old boy presented to a chiropractic clinic with a 10-month history of continuous discharge with a distinctive smell emanating from both his ears. Upon a routine 3-year check-up for his hearing, 4 months prior to consultation, a slight hearing deficit had been identified. This was being reviewed in 2 months’ time with consideration for myringotomy and tympanostomic tube insertion. Cervical and thoracic segmental dysequilibrium was found on static motion palpation, suggesting the presence of a chiropractic vertebral subluxation complex at these levels.
Intervention and outcome: The patient was treated 4 times using cervical paediatric adjusting. Activator technique was applied to the thoracic region. Discharge from the ears disappeared immediately after the first visit. An improvement in hearing was identified at a hearing test 3 months after cessation of chiropractic care. Consequently, myringotomy and tympanostomic tube insertion was considered inappropriate. The patient now uses oil drops to prevent cerruminum accumulation. At 6 years old, he has had no further recurrences of OME and no speech or hearing problems are apparent.
Conclusion: Of the risk factors identified with the onset of otitis media with effusion, this patient exhibited the following: premature birth, breech presentation, low birth weight, time spent in intensive care, exclusive formula feeding, day care attendance and 2 or 3 recurrent episodes of ear infection for which antibiotics were prescribed. Despite these factors, the patient made rapid symptomatic improvement in a single treatment.