Modified Muncie technique, osteopathic manipulation for eustachian tube dysfunction and illustrative report of case

Participants

• Number: 1
• Description: a 37-year-old woman, with intermittent vertigo started a week before. The vertigo episodes would last a few minutes but would leave her disoriented and unable to live peacefully the rest of her day. The symptoms would manifest when she turned her head, sat up from a lying position or got up. She also had muffled hearing in her right ear and reported suffering from seasonal allergies that she kept under control. She did not reporte falls, headaches, visual problems, cough, congestion or presence of mucus at the nasal/pharyngeal level. The physical evaluation revealed a clean throat despite the presence of mucus at the nasal level, while the right tympanic membrane was slightly retracted with the presence of serous fluid. Rinne and Weber’s tests showed a slight conductive hearing loss in the right ear. Some dysfunctions then emerged in the alto-occipital joint, in the cervical vertebrae C2-C4 and the thoracic vertebrae T1-T4.At this point, a diagnosis of serous otitis media due to recent seasonal allergies was issued.

Interventions and evaluations

• 2 sessions of OMT
• OMT: muscle energy, facilitated positional release, high-velocity low-amplitude techniques directed to the cervical and thoracic dysfunctions, and the modified Muncie technique directed to the right ear

Results

The patient felt better after the first session.
However she presented herself again after 2 weeks reporting that the symptoms had reappeared over the last week. She was treated with the modified Muncie technique also during this second visit. After that, the patient reported a complete resolution of her symptoms.

Discussion

Taking into account that Eustachian tube dysfunctions may cause a number of particularly disabling problems (otitis media, tinnitus, vertigo, etc.), simple, safe and effective treatments are particularly useful.
In this case two simple applications of the modified Muncie technique produced the resolution of the patient’s problem. Consequently, this technique can be considered as an adjuvant treatment to the classic therapies, considering that the advantage of the Muncie technique is to directly treat the source of the problem (precisely, the dysfunction of the Eustachian tube) and not just its downstream consequences. It is auspicable that future studies will evaluate the clinical utility of this technique.