Twenty-seven years as an Ear, Nose and Throat Surgeon in a solo, rural practice is a humbling experience. All one's failures return and serve in the community as constant reminders of the fallibility of one's medical care for chronic middle ear disease. It was my frustration with the lack of resolution of these patients' ear disease, their failure on antibiotics, the recurrence of their effusion, the need to repeatedly re-insert tympanostomy tubes and the observation that several patients had seasonal allergic rhinitis which led me to question whether allergy was contributing to their ear disease.
I will share with you how we now successfully manage chronic middle ear disease.
We will look at why some children continually get chronic ear infections (chronic otitis media) with its persistant fluid or effusion (OME), the role of tubes, adenoids, chiropractors, and the effect of hearing loss on children. We will try to explain in lay terms (and scientifically for physicians) how allergy can be responsible for chronic ear disease. We will examine the interrelation of allergy to ear disease, asthma, sinusitis, and smoking. We will provide guidelines for the use of antibiotics and counsel frustrated parents as to what to do to stop the vicious cycle of recurrent middle ear disease and effusion. Most parents will find a case history which matches their own situation for toddlers or school age children - and learn where to seek help.
Our concern is patients who 1) have ear disease which has failed repeated antibiotic treatment, or 2) have tubes which continue to drain, or 3) have tubes which although successful in reducing the frequency of infections, need to be repeatedly replaced. We have proven that successful management of chronic otitis media with effusion depends upon physicians 1) recognizing that OME is a physical sign of allergy, 2) realizing that it is predominantly the atopic or allergic patient who develops OME because of the unique response of the inflammatory cells in their middle ears, and 3) come to understand that like any other allergic disease - only until the host child is identified and treated aggressively for his allergies will the child's ear disease resolve.
Due to the volume of E-mail I have been receiving I cannot keep up with individual replies. Therefore, before sending me a note, please re-read the web pages, especially the "Comments to parents" pages, as I have tried to answer most questions that have come to me. Thanks. DH
meear75travel@gmail.com