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Anatomy of the ear. Printed with permission from the University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine.
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In eustachian tube dysfunction, the eustachian tube fails to open sufficiently, resulting in a difference between the air pressure inside and outside the middle ear. This condition can cause pain and hearing loss and may lead to barotitis media, otitis media, tinnitus, and vertigo. Although several treatment options are available, from antibiotics...
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Whereas it is clear from anatomical studies that all birds have complex interaural canals connecting their middle ears, the effect of interaural coupling on directional hearing has been disputed. A reason for conflicting results in earlier studies may have been that the function of the tympanic ear and hence of the interaural coupling is sensitive...
Citations
... A similar situation arises when changing altitudes on an airplane, which is assisted by chewing gum to use the TVP and MP to help the ET equilibrate middle ear pressure. There are examples in the osteopathic literature of using cranial techniques to treat fascial, osseous, and myofascial restrictions that affect hearing, including techniques to stretch the fascia connected to the LVP, creating a pump that opens the ET [16,18]. Osteopathic textbooks have been advocating this for nearly one hundred years, and similar treatments have been standard in the teaching of OCMM. ...
Adult sudden-onset unilateral sensorineural hearing loss is primarily idiopathic. There are few treatment options with high success rates, but the literature suggests there is equally moderate success with oral or intratympanic steroids, with some evidence to support the use of acupuncture as a salvage treatment. Here, we present a case of sudden unilateral sensorineural hearing loss with otolaryngology evaluation and audiograms before and after osteopathic manipulative treatment (OMT). Osteopathic cranial manipulative medicine (OCMM) directed at eustachian tube dysfunction elicited findings indicating resolution of symptoms was at least partly due to cranial treatment. This report explains a probable anatomic mechanism contributing to hearing loss and suggests treatment options that should be considered as part of the treatment of idiopathic unilateral hearing loss. Future research opportunities are also proposed.
... 3 OMT for ear dysfunction, including MEE, target the eustachian tube to break adhesions, restore eustachian tube opening, normalize middle ear pressure, and encourage fluid drainage . 4 The Muncie technique, developed by Curtis H . Muncie, DO, and its subsequent modified Muncie technique are manipulative treatment options used by osteopathic physicians to relieve eustachian tube dysfunction . 4 Use of this technique dates back to the early 1900's when Muncie performed his technique on William Rockefeller and others, restoring hearing previously thought to be permanently damaged . ...
... 4 The Muncie technique, developed by Curtis H . Muncie, DO, and its subsequent modified Muncie technique are manipulative treatment options used by osteopathic physicians to relieve eustachian tube dysfunction . 4 Use of this technique dates back to the early 1900's when Muncie performed his technique on William Rockefeller and others, restoring hearing previously thought to be permanently damaged . 5,6 Likewise, chiropractic studies have described improved hearing with spinal manipulation . ...
... Current osteopathic case reports and studies have focused on OMT to help drain the middle ear and hasten recovery of acute otitis media and MEE . 3,4 There are 2 main types of hearing loss: conductive and sensorineural . Conductive hearing loss is caused by decreased sound transmission from the external ear to the middle ear, including cerumen impaction, MEE, and trauma . ...
In this case report, osteopathic manipulative treatment restored hearing to an 8-year-old female suffering from conductive hearing loss. Numerous factors can result in hearing loss. In children and adolescents, mild or greater hearing loss occurs with a prevalence of 3.1%.1 Current osteopathic literature focuses on conductive hearing loss due to middle ear effusion (MEE).This case report examines an 8-year-old female presumed to have permanent conductive hearing loss without MEE after a traumatic ATV accident. The use of osteopathic manipulative treatment (OMT) resulted in complete resolution of the patient’s conductive hearing loss. To the authors’ knowledge, this is the first case report documenting the successful use of OMT to treat conductive hearing loss without MEE. Being able to recognize and understand the connection between the primary respiratory mechanism (PRM), which includes the cranial bones and nerves, allows an osteopathic physician to provide a unique approach to patient care and the use of OMT as a treatment modality for conductive hearing loss should be considered.
... Muncie actively engaged in battles over jurisdictional authority of patients who were deaf by harshly condemning allopaths and their theories that otosclerosis and Ménière disease were causes of hearing loss; nevertheless, allopathic treatments for catarrhal deafness followed similar techniques to Muncie's, and osteopaths continued to devise and use modified versions of the Muncie method. 5,12 However, not all patients benefited from Muncie's method. Indeed, some of his patients wrote to the AMA to express their dissatisfaction and regret over lost funds -$3000 or more -and shared their disappointment at discovering that yet another treatment could not restore their hearing (Historical Health Fraud and Alternative Medicine Collection at the AMA archives, folder "Muncie, Dr. Curtis H., Correspondence, 1921-1927" [Box 519, Folder 09]). ...
... He claims that tearing the adhesions between ET and the posterior pharyngeal wall, and crushing granulation tissue (later called the "Royet-Jacod manoeuvre), is very efficient in eliminating many of the complaints. More recently, the same manoeuvre has resurfaced under various names as "pharyngioplasty" [12] and "Muncie technique" [13]. Both techniques are claimed to cure trigeminally related complaints with or without ear complaints. ...
... The Eustachian tube (ET) plays an important role in the function of the middle ear, stimulating its drainage and ventilation. The drainage of secretions from the middle ear and occasionally of foreign material is carried out by the mucociliary system of the tube (and the mucous membrane of the middle ear), the muscular system of the tube and the tension of the lumen tube [1]. The ET is normally closed by periluminal pressure that is greater than the outside, while it is opened rhythmically by muscle activity to which it is directly or indirectly linked [2]. ...
... The bolus of air that comes into the middle ear will be partially absorbed by the blood vessels and mucosa [5]. The ET is nourished by the ascending pharyngeal and meningeal arteries while venous and lymphatic drainage is carried out by the pharyngeal and pterygoid plexus respectively and the retropharyngeal lymph nodes [1]. ...
... In children, the orientation of the sagittal plane is less, averaging at around 10 degrees [7]. It consists of a posterolateral osseous portion and one fibro cartilaginous anteromedial portion, with a length of about 3.5 centimetres [1,8]. The three dimensional structure of the internal lumen is covered with epithelial cells coated by a viscous fluid, and periluminous mucous tissue [1]. ...
... Etiologies of ETD beyond cranial/temporal somatic dysfunction include mass effect from neoplasms, chronic sinusitis whether infectious or related to airborne allergens, upper respiratory tract infections, rapid changes in surrounding pressure (i.e., air travel, scuba diving, etc.), adenoid tonsillar hypertrophy and others. In addition, dysfunction of the pharyngeal musculature including the tensor veli palatini muscle which controls the medial opening of the ET within the nasopharynx and the tensor tympani muscle related to tympanic membrane function is another possible cause of ETD and tinnitus [20]. The tensor veli palatini muscle and the tensor tympani muscle share innervation by the medial pterygoid branch of the mandibular nerve, the third branch of trigeminal cranial nerve (V). ...
... The 2 most common OMTs for OM include: ''Galbreath'' maneuver, a movement of the mandible aimed to indirectly generate a pumping action on the Eustachian tube (ET); 25 and ''Muncie'' and ''modified Muncie'' techniques, the placement of a fingertip on the Rosenmuller's fossa to open the ET. 26 In the largest study so far, combinations of OMTs with antibiotics decreased the frequency of AOM episodes and the insertion of tympanostomy tubes in otitis-prone children, when compared to antibiotics without OMTs. 27 Children who received weekly treatments had fewer episodes of AOM (P ¼ 0.04), and fewer required tympanostomy tubes (P ¼ 0.03). ...
Background: Otitis media (OM) has numerous presentations in children. Together with conventional medical therapies aimed to prevent and/or treat OM, a rising number of complementary and alternative medicine (CAM) treatment options can be offered. Since OM is common in children, parents may ask healthcare professionals about possible CAM therapies. Many physicians feel that their knowledge is limited regarding these therapies, and that they desire some information. Therefore, we conducted a literature review of CAM therapies for OM, taking into account that many of these treatments, their validity and efficacy and have not been scientifically demonstrated.
Methods: We performed a search in MEDLINE (accessed via PubMed) using the following terms: "CAM" in conjunction with "OM" and "children. Retrieved publications regarding treatment of OM in children which included these terms included randomized controlled trials, prospective/retrospective studies and case studies.
Results: The following CAM options for OM treatment in children were considered: acupuncture, homeopathy, herbal medicine/phytotherapy, osteopathy, chiropractic, xylitol, ear candling, vitamin D supplement and systemic and topical probiotics. We reviewed each treatment, and described the level of scientific evidence of the relevant publications.
Conclusions: The therapeutic approaches commonly associated with CAM are usually conservative, and do not include drugs or surgery. Currently, CAM is not considered by physicians a potential treatment of OM, as there is limited supporting evidence. Further studies are warranted in order to evaluate the potential value of CAM therapies for OM.
... Elle permet l'intrusion des secrétions nasopharyngées par pression négative dans l'oreille moyenne et entrave le drainage avec une stase des secrétions [7]. Galbreath en 1920 et Muncie en 1952 [8], deux ostéopathes américains, ont tenté de réduire la dysfonction de la TE en manipulant les muscles tenseur du voile du palais (MTVP) et élévateur du voile du palais (MEVP) étant les principaux responsables de l'ouverture de la TE. Leurs techniques ont été abandonnées faute de validation. ...
La pathogénie de l’otite moyenne (OM) du jeune enfant implique une interaction entre une infection virale ou bactérienne et une dysfonction de la trompe d’Eustache (TE). On recherche l’ouverture de la TE pour provoquer l’aération de l’oreille moyenne. Ce travail vise à valider une nouvelle manipulation pour traiter la dysfonction de la TE en manipulant les muscles tenseur du voile du palais (TVP), élévateur du voile du palais (EVP) et salpingo-pharyngien (SP). Une étude a été menée sur 60 patients âgés entre quatre et 49 mois atteints d’OM, avec ou sans effusion. Les enfants ont été répartis au hasard en deux groupes A (n = 31) et B (n = 29). Le diagnostic de l’OM a été confirmé pour les deux groupes par tympanométrie (courbe de classe B ou C de la classification de Jerger). Le groupe A a eu une première tympanométrie suivie de la manœuvre ostéopathique. Une heure après, une deuxième tympanométrie de contrôle a été effectuée. Le groupe témoin B a reçu une tympanométrie suivie, une heure après, d’une autre tympanométrie de contrôle, sans manœuvre. La tympanométrie de contrôle reste inchangée pour le groupe B (p intragroupe = 0,999). Pour le groupe A, le profil de contrôle s’inverse (p intragroupe < 0,001), et 71 % des sujets ont récupéré en classe A de la classification de Jerger. Cette technique est efficace pour ouvrir la TE chez les enfants atteints d’une OM. Nous pourrions envisager, en prévention de l’OM, d’utiliser cette manœuvre chez les enfants atteints de bronchiolite ou de rhinopharyngite et d’évaluer les conséquences sur la fréquence d’apparition de l’Otite.Niveau de preuveII.
... The second is the Muncie Technique, which attempts to correct Eustachian tube dysfunction by applying a pumping action with the index fi nger in the vicinity of the palantine tonsil. Channell reports a case of a patient with vertigo who was successfully treated with a modifi cation of the Muncie technique, 22 however, no studies on either technique are presented. The technique used in the cases reported here was one in which the thumb is placed just inside the intertragic notch, with the proximal interphalgeal joint of the index fi nger contacting just inside the lobule (fi gure 1). ...
To report and discuss four cases of ear pain which were treated successfully with manual therapy.
Report of four cases.
Four patients with ear pain were referred for chiropractic consult. They were all treated with a combination of manual therapy and exercise with resolution of their ear symptoms.
The mechanism of idiopathic ear pain that may be amenable to manual therapy is not fully known. Further research is needed to investigate the etiology of this disorder and to determine whether manual therapy and exercise are viable options in some patients with idiopathic ear pain. In the meantime, it may be advantageous for otolaryngologists to seek input from physicians skilled in assessment and treatment of the musculoskeletal system in cases ear pain for which an otolarygologic etiology cannot be found.
... Moving the finger tip cephalad and slightly lateral to the Rosenmüller fossa, posterior to the opening of the Eustachian tube, the osteopathic physician should apply a pumping motion with the finger pad to lyse any adhesions and, ultimately, restore the Eustachian tube opening. However, this technique may cause gagging and can be traumatic for children (30). The accompanying illustrative case report presented was a 37-year-old patient reputedly cured of intermittent vertigo by Eustachian tube manipulation. ...
Throughout history, false and outrageous cures for deafness have been abundant. Most of these false remedies were short lived and did not gain much attention. However, Curtis H. Muncie, a New York osteopathic physician, accrued vast wealth and fame over a half century career (1910-1960) with his proclaimed cure of deafness through reconstruction of the Eustachian tube with his index finger. Through creative marketing, clever manipulation of the press, and outrageous claims of efficacy, he profited handsomely from what was, no doubt, the most egregious and remunerative instance of deafness quackery in 20th century otology.
A collection of original pamphlets issued by Curtis H. Muncie between 1921 and 1960 supplemented by articles from the popular press and both osteopathic and medical journals.
The evidence that Dr. Muncie used unscientific methods and unscrupulous business practices is overwhelming. Famously, he fraudulently claimed in 1923 and for years thereafter that he had cured a congenitally deaf Spanish Prince (Don Jaime). At the height of the depression, his magical finger earned him over half a million dollars. Even his 1942 prison sentence for tax evasion did not keep him from resuming his flimflam upon his release.
The story of Curtis H. Muncie is the quintessential example of how desperate patients can be exploited by an unscrupulous practitioner whose goal is satisfying his own avarice rather than curing illness.
