Author: Trude Anita Degen
Supervisor: L. Henrik Mathiesen Dr.
Introduction: The NICE guidelines only recommend osteopathy as a treatment for persistent lower back pain. According to the guidelines, there is limited or no evidence for treatment effects of other conditions unrelated to the musculoskeletal system, but what about paediatric otitis media?
Objective: This study had two purposes, to summarize various medical and osteopathic examination and treatment methods of paediatric otitis media and to perform a systematic review of clinical trials concerning the efficacy of osteopathic manipulative treatments / techniques of otitis media in infants and children, 0-6 years old.
Method: A systematic literature research in databases, search engines and journals was carried out in the period from August to October 2014. Studies that met the inclusion criteria were retrieved in full for further evaluation. The following data was extracted from the included trials: first author and year of publication, objective, trial design, patients characteristics, intervention, primary outcome measures, adverse effects, follow up period, main results and conclusions. A quality assessment of each study was performed individually depending on the study design.
Results: The initial search strategy yielded 523 articles. Eight articles met the inclusion criteria, and one additional study was included due to its relevance. Seven articles investigated the efficacy of osteopathic manipulative treatments on acute otitis media based on the inclusions criteria. One trial investigated the efficacy of osteopathic manipulative treatments of otitis media with effusion (secretory otitis media) in accordance with the inclusion criteria and one additional article studied the effect of suture restriction of the temporal bone as a risk factor for acute otitis media.
Conclusion: Despite the lack of comparable trials concerning the efficacy, the current status of conventional treatment of otitis media reveals a high incidence of prescribed antibiotics and surgical interventions. All trials on the efficacy of osteopathic manipulative treatments on otitis media showed promising results with no known adverse effects although the number of osteopathic trials included were small and not of high validity. This review supports the efficacy of osteopathic manipulative treatments on otitis media in children aged 0-6 years as an adjuvant therapy. Several trials included provided compelling evidence for the efficacy of osteopathy in combination with objective measurements. Further studies would be beneficial to confirm the results of the articles included in this review.