Osteopathic Manipulative Treatment for Children With Chronic or Recurrent Otitis Media

The Role of Osteopathic Manipulative Treatment (OMT) in Children With Recurrent or Chronic Otitis Media Prior to Tympanostomy Tube Surgery: A Randomized Clinical Trial

The goal of this clinical trial is to learn whether osteopathic manipulative treatment, or OMT, can reduce the need for tympanostomy tube surgery in children with recurrent or chronic otitis media who have been referred to an Ear, Nose, and Throat surgeon and are being considered for tympanostomy tube placement.

The main question it aims to answer is:

Can a standardized OMT protocol, given once weekly for 4 weeks before the final surgical decision, reduce the rate of tympanostomy tube surgery in pediatric patients with recurrent or chronic otitis media?

Researchers will compare children who receive the standardized OMT protocol with children who receive a placebo/control manual treatment protocol to see whether OMT leads to a clinically meaningful reduction in the need for surgery.

Participants will:

• Attend 4 weekly study visits before their final ENT surgical decision.
• Receive one of several assigned combinations of standardized OMT intervention procedures and control manual procedures. Each participant's assigned treatment sequence is determined by randomization.
• Complete study-related assessments and questionnaires related to ear symptoms and quality of life.
• Continue their planned ENT care, including follow-up evaluation with the ENT surgeon to determine whether tympanostomy tube surgery is still recommended.

Inclusion Criteria:

• Age 6 months to less than 7 years. (All participants)
• Referred to an otolaryngologist (ENT) for evaluation of chronic otitis media with effusion (OME) or recurrent acute otitis media (AOM). (All participants)
• Planned for tympanostomy tube placement (unilateral or bilateral) pending surgical decision. (All participants)
• At least 5 weeks between enrollment and anticipated surgical decision point. (All participants)

Exclusion Criteria:

• Congenital or developmental conditions associated with increased otitis media risk, including but not limited to Down syndrome, cleft palate, or other craniofacial abnormalities. (All participants)
• History of prior tympanostomy tube placement or current tympanostomy tubes in place. (All participants)
• History of tympanic membrane perforation. (All participants)
• Presence of preauricular pits. (All participants)
• Patients requiring urgent or expedited surgical intervention, as determined by the treating ENT physician. (All participants)