Homoeopathy in acute otitis media: a case report

Dr Geethanjali. M

INTRODUCTION:
Acute otitis media (AOM) is a disorder characterised by inflammation, swelling and redness of the middle ear cavity, along with auditory ossicles and Eustachian tube. AOM occurs when child’s Eustachian tube becomes swollen or blocked and traps fluid in the middle cavity.¹

PREVALENCE:

Otitis media is highly prevalent worldwide and is the main cause of hearing impairment in developing countries. WHO reported that hearing impairment in 42 million people in the world is mainly due to otitis media. Prevalence of otitis media varies in different countries, populations, and ethnic groups.⁴

Acute otitis media is a very common condition and a leading cause of health care visits. Studies carried out in developed countries show that 80% of children will have experienced at least one episode of acute otitis media by their 3^rd birthday and 40% will have six or more recurrences by the age of seven years.⁶

AOM may have long term effects on early communication, language development, auditory processing, psychosocial-cognitive development, educational progress and achievement.⁵

The complications pose a threat in low- income countries. The global prevalence of hearing loss associated with otitis media is estimated at 30 per 10,000 individuals. Perforated eardrum is commonly seen as a local sequel of AOM. Recurrent AOM cause frequent episodes of acute ear pain, fever, and general illness and considerable distress to children and their parents. In case of suppurative AOM, complications include acute mastoiditis, meningitis, and brain abscesses which are rare but potentially serious.⁵

HOMOEOPATHIC THERAPEUTICS:

Belladonna: Tearing pain in middle and external ear. Humming noises. Membrane tympani bulges and injected. Sensitive to loud noises. Hearing very acute. Otitis media. Acute and subacute conditions of eustacjian tube.³

Ferrum phosphoricum: Noises, throbbing. First stage of otitis. Membrane tympani red and bulging. Acute otitis, when belladonna fails, prevents suppuration.³

Hepar sulphuricum: Discharge of fetid pus from the ears. Whizzing and throbbing in the ears, with hardness of hearing. Deafness after scarlet fever. Pustules in auditory canal and auricle. Increase of cerumen. Hardness of hearing, with pulsations and buzzing in ears especially in the evening in bed. Heat redness and itching in ears.²

Pulsatilla: Otorrhea with throbbing tinnitus. Roaring and humming in ears. Hardness of hearing as from an obstruction. Cerumen hard and black. Bland, offensive discharge from one or both ears.catarrhal otitis. Otalgia worse at night.²

Mercurius solubilis: thick, yellow discharge; fetid and bloody. Otalgia, worse warmth of bed; at night. Sticking pains. Ear and auditory tube inflamed. Discharge of pus from ear. Hardness of hearing, sometimes with obstruction of ears- tinkling, roaring, ringing and buzzing in ears principally in evening.²

CASE REPORT:

A 6 year old boy was brought to the out patient department of Government Homoeopathic Medical College Hospital, Bengaluru on 15/5/23 with the complaint of earache and discharge from ears since 3 days.

History of presenting complaints: child was apparently healthy until the past 3 days when he started with earache and discharge from ears.. he also has itching in ears.

• There is no history of any other underlying systemic disorders, inflammation of outer ear.
• Past history: Nothing significant.
• Family history: MGM-DM, MGF-HTN
• Allergic history: Not allergic to dust, drug and diet.
• Personal history:
• Appetite: reduced
• Thirst: adequate.
• Bowel habits: Regular, once in a day.
• Bladder habits:3-4 times / day, once at night
• Sleep: disturbed due to pain.
• Thermals- chilly patient.
• Activity- reduced
• O/E: Fetid thick discharge from ear.

Sensitiveness to touch.

The severity of patient’s complaints was assessed based on AOM-SOS SCORE⁷(Acute Otitis Media Severity Of Symptom Score) which includes the following 7 observable behaviours:

• Ear tugging
• Crying
• Fussiness
• Disturbed sleep
• Decreased play
• Eating less
• Fever

Outcome:

Recovered: Disappearance of symptom and no recurrence of same during the study period. AOM-SOS scale reducing to zero along with general well- being of the subjects and improvement of generals.

Improved: Relief of symptoms but again occur within the end of the study period with lesser intensity, AOM-SOS scale shows improvement.

Not improved: No change in symptoms even after sufficient time of treatment, AOM-SOS Scale shows no improvement.

The signs of acute inflammation can be demonstrated by otoscope.

The score before treatment for the patient was 8 out of 14.

Totality of symptoms:

• Earache
• Discharge of fetid pus from ear.
• Itching in ear
• Reduced appetite
• Disturbed sleep
• Activity reduced.

Prescription: Hepar sulpuricum 200/ 1 dose

Discussion:
Homoeopathy  consider patient as a whole and the physician treat accordingly by arriving at the similimum by individualising the patient according to the directions given by Master Dr Hahnemann.Follow up was done once in a week for a month and once in 15 days for 3 months. After the first follow up the complaints of patient reduced drastically.The AOM-SOS score of patient after the first follow up reduced to 1 and at the end of 2 weeks 0 i.e, patient recovered.

Conclusion:
Acute otitis media is a very common condition and a leading cause of health care visits. It not only affects the health status of child but also affects the quality of life of the child as well as their family members.

Homoeopathic medicines are very patient friendly and acts in a very gentle and effective way. It helps the patient to enjoy his higher purpose of existence.

Declaration of patient consent: Parent of  patient was explained about the study and consent was obtained.

Conflict of interest: NIL

Reference : 

1. Gupte The Short Textbook of Paediatrics.12 e/d(2), New Delhi: Jaypee brothers;2016.
2. H J,Dictionary of practical material medica,first indian edn,1978,B Jain publishers(p) LTD,898.
3. Boericke William-pocket manual of Homoeopathic material medica and repertory, reprint edn1994,B Jain Publishers(P)LTD.New Delhi;573.
4. World Health Organisation, ICD-10 classification of mental and behavioural disorder: clinical description and diagnostic guidelines, Geneva,2021 https://www.icd10data.com/ICD10CM/Codes/H60-H95/H65-H75/H66-/H66.90
5. . Santoshi Kumari M et al. Prevalence and associated risk factors of otitis media and its subtypes in South Indian population.Egypt J Ear Nose Throat Allied Sci 2016 https://www.infona.pl/resource/bwmeta1.element.elsevier-8d46d78e-6c73-302a-b900-4ab509b903e7
6. Frei H, Thurneysen A ,Homoeopathy in acute otitis media in children: treatment effect or spontaneous resolution, British Homoeopathic Journal(2001) https://pubmed.ncbi.nlm.nih.gov/11680801/
7. Nader sheikh, , Hoberman alejandro,Paradise Jack,Rockette Howard,Kurs-lasky Marcia,Colborn D. et al.  et al. , responsiveness and construct validity of a symptom scale for acute otitis media, Pediatric infectious disease journal.2009 jan (cited on july 20.2021)https://pubmed.ncbi.nlm.nih.gov/19077916/

Dr Geethanjali. M
PG Scholar, GHMC, Bangalore