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Otitis Media

 

Otitis Media Introduction

:ear.jpg Acute Otitis Media, or ear ache, is a common childhood illness that may also occasionally occur in older children and adults. This condition often occurs secondary to an upper respiratory tract infection (URI), though it can occur by itself as well. A viral or bacterial infection is usually to blame, and treatment must be geared towards the correct causative organism.

Acute Otitis Media occurs when organisms move through the Eustachian tubes into the middle ear, and there cause infection. [1] Eustachian tubes are those that connect the throat to the middle ear, and allow the pressure in the middle ear to remain normal with the outside air.

Otitis Media Symptoms

In acute otitis media, the onset of symptoms is usually rapid. Symptoms can include;

  • Ear pain
  • Fever up to 105 (physician should be contacted at 103)
  • Runny nose
  • Nasal congestion
  • Cough
  • Irritability
  • Lethargy
  • Vomiting and diarrhea are more common in younger children.

Infants will tend to pull at their ears, and often will refuse to nurse or sleep. There may also be fluids that ooze from the ear canal that may be purulent and/or bloody in appearance. [2] A steady increase in the intensity of symptoms, followed by a sudden cessation of symptoms (i.e. infant stops crying), may be a key indicator that the eardrum has burst. There are several other signs and symptoms that must be interpreted by a physician.

Treatment for Otitis Media (ear infections)

In general, naturopathic treatments for otitis media (ear infections) should be tried for a maximum of 2-3 days. If there is not a major reduction is symptoms by that time, antibiotic treatment is indicated under the supervision of a qualified ND or MD. If there is extreme tenderness behind the ear, dilation of the pupils, stiffness of the neck, projectile vomiting, or the child becomes unresponsive to external stimuli, then a physician should be contacted immediately as these may be signs of a serious complications.

Supplements helpful for Otitis Media

Vitamins and Minerals:

There are a number of nutrients that have shown promise in the treatment of Otitis Media, as well as for overall immune health. Interestingly, a large number of deficiencies have been noted in children with otitis media, upper respiratory infections, and other conditions adversely affecting immune function. Among the main deficiencies, are Zinc and Selenium. [3] Conversely, nutrients like Vitamin C have shown a preventative effect on lowering one’s risk of developing early Otitis Media.[4] Additionally, Vitamin E, Vitamin A, and, Beta-carotene are also helpful in supporting the immune system and regulating allergic responses, which may contribute to the development of Otitis Media. [5]

Thymus extract:

Thymus extract is available in two forms; a polypeptide extract and whole calf thymus that has been freeze dried. This extract has been researched for a number of purposes, including HIV treatment, mitigating allergic reactions, boosting the immune response, cancers, and many others. There are studies that show that Thymus extract can be effective in these applications. The specific properties relevant to the treatment of Otitis Media are the ability of thymus extract to moderate allergic reactions and to stimulate the immune response. There are some considerations that must be taken into account before using any glandular product, as these products do come from animals and represent a potential vector for infection. Although, it is important to note that no cases of illness have been reported from the use of thymus extract. There have, however, been two reported cases of toxic effects from thymus, resulting from allergic reactions to the components of the products used. [7, 8]

N-Acetyl Cysteine:

N-Acetyl Cysteine (NAC) is an amino acid that plays a role in the body as a precursor for Glutathione, a critical anti-oxidant that keeps the body safe from dangerous oxygen quenching free radicals. NAC has another effect when taken as a nutritional supplement. N-Acetyl Cysteine has been shown to thin mucus secretions and may be used to facilitate draining of congestion. By thinning the mucus, congestion is lessened and there is less substrate for the growth of bacteria and other pathogenic agents. Specific anti-inflammatory properties of NAC are also useful in helping to relieve the symptoms of OM. It has been demonstrated that NAC is a safe and effective treatment for Otitis Media in various clinical applications. [9]

Internal Botanical Treatments- Echinacea:

Species of echinacea have long been used in botanical medicine. These unique herbal medicines demonstrate numerous medicinal qualities, including anti-viral, anti-inflammatory, vulnerary (wound healing), and anti-microbial activities. All of these properties can prove useful in the treatment of upper respiratory tract infections, including those associated with Otitis Media. Echinacea has a established track record with regard to URIs. In fact, several studies have demonstrated the herb’s efficacy in treating and preventing illnesses of the upper respiratory tract. [10-11]

Topical treatments for Otitis Media:

Ear oils and glycerites have been traditional herbal remedies for OM, of which there are many different formulae and philosophies. Typically, the carriers for these ear preparations is either oil or glycerin (known as glycerites) with various herbal ingredients added. There is some debate about which carriers are appropriate, as there is concern about whether or not glycerin could serve as a food for microbes in the ear canal, including various fungi. The advantage of glycerites is that they form an osmotic gradient across the tympanic membrane (eardrum) that can be helpful in cases of serous effusion (fluid) in the inner ear. Some of these preparations have performed as well as pharmacological agents developed for the same purpose. [12] Common herbal additives in ear formulae include; Garlic (allium spp), Mulllien (Verbascum), and Goldenseal (Hydrastis).

Example Usage:

Place bottle of ear drops under warm water for a few minutes to ensure that the drops are warm enough to flow freely and not cause discomfort to the child. Instill 2-4 drops of the preparation into each ear at bedtime or as needed, and loosely insert a cotton ball to prevent the drops from flowing out of the ear. If the earache does not significantly improve then it is necessary to refer to a physician for possible antibiotic therapy. If eardrum rupture is suspected, no product should be applied into the ear. Immediate medical attention is recommended. [13]

References

[1] Beers and Berkow, Merck Manual, 17th ed. (Whitehouse station, NJ: Merck Research Laboratories, 1999) 673-674.

[2] Beers and Berkow, Merck Manual, 17th ed. (Whitehouse station, NJ: Merck Research Laboratories, 1999) 673-674.

[3] Chandra RK, Trace element regulation of immunity and infection. J Am Coll Nutr 4(1):5-16, 1985.

[4] Daly, KA et al. Epidemiology of otitis media onset by six months of age. Pediatrics. 1999 June;103(6):1158-66.

[5] Pinncock CB et al. Vitamin A status in children who are prone to upper respiratory tract infections. Austr Ped J 22(2):95-99, 1986

[6] Murry and Pizzorno, Encyclopedia of natural Medicine (Roseville, CA: Prima Health, 1998) 440-447.

[7] Fiocchi A, Borella E, Riva E, Arensi D, Travaglini P, Cazzola P, Giovannini M. A double-blind clinical trial for the evaluation of the therapeutical effectiveness of a calf thymus derivative (Thymomodulin) in children with recurrent respiratory infections. Thymus. 1986;8(6):331-9

[8] Genova R, Guerra A. Thymomodulin in management of food allergy in children. Int J Tissue React. 1986;8(3):239-42.

[9] Wilson, James. Thymus Extracts: International Literature Review of Clinical Studies.

[10] Ovesen T, Felding JU, Tommerup B, Schousboe LP, Petersen CG. Acta Otolaryngol Suppl. 2000;543:79-81. Effect of N-acetylcysteine on the incidence of recurrence of otitis media with effusion and re-insertion of ventilation tubes.

[11] Cohen HA, Varsano I, Kahan E, Sarrell EM, Uziel Y. Effectiveness of an herbal preparation containing echinacea, propolis, and vitamin C in preventing respiratory tract infections in children: a randomized, double-blind, placebo-controlled, multicenter study. Arch Pediatr Adolesc Med. 2004 Mar;158(3):217-21.

[12] Melchart D et al.Immunomodulation with echinacea- a systematic reviw of controlled clinical trials. Phytomedicine 1994;1:245-54.

[13] Sarrell EM, Mandelburg A, Cohen HA. Efficacy of naturopathic extracts in the managment of earpain associated with acute otitis media. Arch Pediatric Adoes Med 2001;155(7) 796-799.

[14] Conroy K, Yarnell E. Naturopathic approach to Ophthalmology and Otolaryngology 4th ed. 2002. Healing Mountain Publishing. Wenatchee, WA.