By Dr. Christopher Kent
I recently saw a television documentary featuring medical physicians Hamilton Hall and Murray Katz.
The doctors spoke into the lens of the camera without flinching, claiming there was no evidence to support the use of chiropractic care for patients suffering from a variety of health problems. One condition discussed was otitis media in the pediatric population.
Dr. Katz stated that when it comes to antibiotics, he would rather err in the direction of prescribing them. I’m thankful that I am not his patient.
This column will address some of the evidence which Drs. Hall and Katz were unfamiliar with or elected to ignore.
Otitis media has attracted considerable attention lately because of its economic impact. The age of accountability has resulted in responsible parties taking a second look at the safety and efficacy of common treatments for otitis media.
Froom et al reported on the results of a study involving 3,660 children in nine countries. The authors concluded, “Antibiotic treatment did not improve the rate of recovery of patients in this study.” In fact, they stated, “Patients who did not take antibiotics had a higher rate of recovery than those who did…” [1]
In a review of literature, Lehnert stated, “In a review and critical appraisal of the literature on antibiotic therapy for acute otitis media in children between 1939 and 1991, poor evidence supported the routine use of antibiotic therapy.” [2]
If antibiotic therapy is pronounced unsuccessful, tympanostomy tubes are often recommended. Unfortunately, most children who have the procedure have recurrent effusion within two months [3] and up to 25% may have total hearing loss [4].
It is amazing that in the face of this evidence, as well as the attendant risks and costs, antibiotics and surgery remain the treatments of choice in most pediatric medical practices. The matter is worsened by the fact that the problems associated with tympanostomy tubes were reported decades ago in the literature.
Is there anything in the refereed literature supporting chiropractic care in children with otitis media?
Yes.
Hendricks and Larkin-Thier reviewed the literature supporting a physiologic rationale for chiropractic management of otitis media. [5]
Froehle published the results of a retrospective study of 46 children aged five years and under with otitis media. 93% of all episodes improved, 75% in 10 days or less. [6]
Fysh described a case series of five patients five years of age or under with chronic recurrent otitis media. Each of the children responded favorably to chiropractic care. [7]
Heagy reported favorable results in four cases of otitis media in children. [8]
Other case reports may be found in the peer reviewed literature.
Peet published a case study of a five-year-old male with recurring otitis media. Pre- and post- radiographs were included in the paper demonstrating correction of the biomechanical component of the vertebral subluxation. [9]
Additional case studies have been published by Marko [10] and Webster [11] reporting favorable results in children with otitis media.
It must be remembered that chiropractic is not the treatment of any disease, including otitis media. Rather, it is acknowledged that when vertebral subluxations are corrected, otitis media frequently resolves.
Chiropractic care should be a part of everyone’s life from the moment of birth to the time of passing on. Chiropractic care places the patient on a physiologic path which allows the body to express its potential without interference.
Doctors of chiropractic who care for children may wish to obtain copies of some of the papers cited for patient education. Copies are available for a small fee from most chiropractic college libraries.
It is important for parents making health care decisions to remember the words of Dr. Sid Williams: “Chiropractic first, medicine second, surgery last!”
References
1. Froom J, Culpepper L, Grob P, et al: “Diagnosis and antibiotic treatment of acute otitis media: a report from the International Primary Care Network.” BMJ (1990) 300(6724):582.
2. Lehnert T: “Acute otitis media in children.” Role of antibiotic therapy. Can Fam Physician (1993) 39:2157.
3. Mackinnon D: “The sequel to myringotomy for exudative otitis media.” J Laryngol Otol (1971) 85:773.
4. Stangerup SE, Tos M: “Etiologic role of suppurative otitis media in chronic secretory otitis.” Am J Otol (1985) 6:126.
5. Hendricks CL, Larkin-Thier SM: “Otitis media in young children.” J Chiropractic Research, Study and Clinical Investigation (1989) 2:9.
6. Froehle RM: “Ear infection: a retrospective study examining improvement from chiropractic care and analyzing the influencing factors.” JMPT (1996) 19(3):169.
7. Fysh PN: “Chronic recurrent otitis media: case series of five patients with recommendations for case management.” Journal of Clinical Chiropractic Pediatrics (1996) 1(2):66.
8. Heagy DT: “The effect of correction of the vertebral subluxation on chronic otitis media.” Chiropractic Pediatrics (1996) 2(2):6.
9. Peet JB: “Chiropractic results with a child with reoccurring otitis media accompanied by effusion.” Chiropractic Pediatrics (1996) 2(2):8.
10. Marko R: “Chiropractic biophysics technique in care of a child with otitis media.” Chiropractic Pediatrics (1996) 2(2):13.
11. Webster L: “A review of two typical chiropractic cases involving otitis media.” Chiropractic Pediatrics (1996) 2(2):14.
