Journal: Journal of Clinical Chiropractic Pediatrics 1997;2(2):167-183
Author: Fallon, JM
Objective: To conduct a pilot study of chiropractic adjustive care on children with otitis media using tympanography as an objectifying measure, and to propose possible mechanisms whereby subluxation is implicated in the pathophysiology of otitis media.
Design: Case series.
Setting: Subjects presented in a private clinical practice in New Rochelle, New York. The subjects were referred by various sources including pediatricians, other MDs, chiropractors and parents.
Participants: 332 children who presented consecutively with previously diagnosed otitis media, ages 27 days to 5 years.
Main outcome measures: A survey of the parent/guardian was used to determine historical data with respect to previous otitis media bouts, age of onset of initial otitis media, feeding history, history of antimicrobial therapy, referral patterns, and birth history. Otoscopic and tympanographic data was collected as well as data concerning the number of adjustments administered to produce resolution of the otitis media. Data with respect to recurrence rates over six months was also collected.
Results: The average number of adjustments administered by types of otitis media were as follows: acute otitis media (n=127) 4.0±103, chronic/serous otitis media (n=104)±1.53, for the mixed type of bilateral otitis media (n=10) 5.3±1.35 and where no otitis was initially detected on otoscopic and tympanographic exam (but with history of multiple bouts) (n=74) 5.88±1.87. The number of days it took to normalize the otoscopic examination was for acute 6.67±1.9, chronic/serous 8.57±1.96, and mixed 8.3±1.00. The number of days to took to normalize the tympanographic examination: acute 8.35±2.88, chronic/serous 10.18±3.39, and mixed 10.9±2.02. The overall recurrence rate over a six month period from initial presentation in the office was for acute 11.02%, chronic/serous 16.34%, for mixed 30% and for none present 17.56%.
Conclusion: To our knowledge this is the first time that tympanography has been used as an objectifying tool with respect to the efficacy of the chiropractic adjustment in the treatment of children with otitis media. As tympanography has been used extensively in the medical assessment of children with otitis media, it also serves as a bridge from which the chiropractic field and the medical field can begin to communicate with respect to otitis media. The results indicate that there is a strong correlation between the chiropractic adjustment and the resolution of otitis media for the children in this study. This pilot study can now serve as a starting point from which the chiropractic profession can begin to examine its role in the treatment of children with otitis media. Large scale clinical trials need to be undertaken in the field using tympanography as an objectifying measure. In addition, the role of the occipital adjustment needs to be examined. This study begins the process of examining the role of the vertebral cranial subluxation complex in the pathogenesis of otitis media, and the efficacy of the chiropractic adjustment in its resolution.