Otitis media is a disorder involving inflammation of the middle ear that’s often caused by viral or bacterial infections, or more commonly, a viral infection with a secondary bacterial infection. There may also be an association with allergies. The disorder is classified into acute otitis media (AOM) or the more chronic suppurative otitis media (CSOM). The symptoms that are usually seen in AOM include ear pain, fever, irritability, poor appetite, hearing loss and redness and bulging of the tympanic membrane. CSOM may follow from AOM and usually involves hearing loss, a discharge from the ear through a perforated tympanic membrane with a reduction in or absence of pain1, 2.
Otitis media is frequently experienced by young children who may be seen pulling on the affected ear and crying from the pain. AOM affects approximately 11% of the population with around half of those being young children3. The factors that increase the risk for AOM include daycare, feeding children while lying down, a lack of breastfeeding or early weaning, exposure to airborne pollutants and the use of pacifiers. The medical management of ottitis media may involve the use of antibiotics, ibuprofen, paracetamol, benzocaine ear drops and grommets as a means of draining the middle ear. For more than 82% of people who experience AOM, the disease will pass without treatment being required4 and it’s a matter of debate as to whether the side effects from antibiotics, often the first-line treatment, is worth that risk. AOM is one of many diseases where complementary medicine approaches are preferable to orthodox medicine and of the various modalities that may be of value here, homeopathy has been shown to be particularly useful, both anecdotally and experimentally 5, 6, 7, 8, 9.
Following are brief discussions on some of the more prominent homeopathic medicines used in this disorder.
Homeopathically, the Pulsatilla picture is characterised by changeable symptoms. The individual typically displays a mild gentle, weepy and clingy disposition, appears chilly, fears being alone at night, has a pale face, fever, is thirstless, and develops a very painful left-sided ear infection with a thick bland offensive otorrhoea, tinnitus and deafness, following an upper respiratory tract infection. There may be fever, a thick yellow or green nasal discharge and a desire for open air. The sufferer often wants the head high when lying down. The external ear may be swollen and red. Symptoms may be worse at night, from heat, a warm room, after eating, from rest, from lying down or lying on left side or painless side, and better from open air, motion, cold applications, cold food and drink, and sitting erect.
This medicine is frequently useful where there is a rapid and violent onset of symptoms that involve mental excitement, anxiety, sensory hyperaesthesia, pupil dilation, cold extremities, redness and acute inflammation. The tympanic membrane is often bright red and bulging, there may be a bright, dry, red throat, pounding, throbbing pain in the right ear, dry skin, an aching in the face extending to the neck, a high fever, and a bright red or flushed face. The otitis may be associated with teething and symptoms come and go quickly. The symptoms are usually worse from jarring, from a draught, from light or noise, and are usually better from bed rest and in a warm room.
The Chamomilla sufferer is never pleased, is restless, angry and irritable, thirsty, hot, experiences night sweats, is impatient, rejects things that are offered, and strikes others. The prescriber may notice that one cheek is red and hot while the other is pale. Like Belladonna, the otitis here often occurs with teething. The otitis pain frequently causes screaming or whining. The symptoms are worse heat and at night, from teething, and better from being carried and from perspiration
A severe sore throat, prostration, fever, night sweats, moist skin, thick offensive yellow or green discharges, profuse sweating, swollen lymph nodes, ear pain and excessive salivation may be indicators for this prescription. The sufferer often experiences tremors in the extremities, is chilly, craves bread and butter and cold drinks. Symptoms are worse at night, from heat, a warm room, a warm bed, and from perspiration.
Hepar sulph can be very useful for those suffering from chronic otitis with pharyngitis, deafness, perforations or ulceration of the tympanic membrane, and a yellow purulent cheesy offensive effusion, all of which may progress to mastoiditis. Often, pain can be felt shooting from throat to the ear on swallowing. The sufferer may be irritable and experience cold sweats, hyperaesthesia, may be sensitive to touch. Injuries tend to suppurate and there may be a history of bacterial infections. Symptoms are often worse from cold air, dry cold wind and touch, and better from heat, damp weather, wrapping up, from rest and in the morning.
This medicine may be required to be used as an intercurrent when other well-indicated medicines fail to act. The pointers here include restlessness, aggression, a dislike of bathing, frequent skin eruptions, relapsing complaints, itchy skin, tinnitus, deafness, ailments from milk, and a desire for sweets. The sufferer may experience morning diarrhoea, profuse urination, respiratory congestion, hot sweaty hands, as well as flushes of heat with dry skin. The body generally appears to be unclean. The symptoms here are commonly worse warmth in bed, in the early morning, from washing or bathing, and better during warm dry weather and in the open air.
The symptoms guiding the prescription of Capsicum include a high fever, chills, stinging, stabbing or burning ear pain with suppuration, a hot face, halitosis, red cheeks, pain and dryness in throat, inflamed fauces, uvula and palate, as well as mastoiditis. The body may appear to be unclean. Symptoms are worse from cold, on coughing in the open air and from draughts, and better from heat and eating.
The presence of offensive muco-purulent otorrhoea, night sweats, photophobia, swollen tonsils, enlarged glands and deafness, particularly when teething is occurring at the same time or there’s been a history of delayed dentition, may indicate the need for Calc carb. There may be a desire for cold drinks, eggs, milk and things that are normally indigestible. The sufferer may appear to be obstinate, may perspire easily, particularly about the head and at night and exhibit a sour odour, and may complain of a sensitivity to cold around the ears and neck. The symptoms are worse from cold weather, from drinking milk or washing, and better from lying on the affected side and from dry weather.
In this instance, symptoms often start on the right side, then either stay there or travel to the left. Other indicators include tinnitus, deafness, thick yellow offensive otorrhoea, a desire for sweets and warm food, increased appetite, flatulence, cold extremities, dry skin, intermittent chills and sweats and hyperaesthesia to noise. Symptoms are worse in the late afternoon to evening or on waking, from warmth and are better from motion, from cold applications and from being uncovered.
Kali bichromicum is often thought of in chronic situations involving a perforation of the ear drum accompanied by a muco-purulent discharge. Involved tissues are irritable, there may be a stringy or globular yellow nasal discharge, a dry mouth and throat, sinus headache and fever. Symptoms are worse on the left side, in the morning and from cold, and are better from heat.
On examination, one may note a drum head that is dark purple, with elevated spots in the local area that form vesicles which break and produce a watery acrid excoriating discharge that smells of fish. Symptoms tend to develop slowly and deafness may occur. Symptoms are worse at night, from cold, touch, and lying on affected side. Symptoms are better from lying on the back.
Chronic otitis with mastoid involvement and excessive granulation occurring in the inner third of the auditory canal often respond well to this medicine. Swollen glands, flatulence, deafness, tinnitus and a history of glue ear and tonsillitis may also be noted here. Symptoms are worse from motion, open air, cold drinks, and are better from rubbing.
Ferrum phos is frequently thought of as being useful in the early stages of all febrile and inflammatory disorders, and as such is useful in the early stages of otitis. Specific indications include inflammation and bulging of the tympanic membrane, lassitude, feverish and yet chilly at around 1pm, tinnitus and flushing of the face. Symptoms are worse on the right side, at night and from 4-6am, from touch or jarring, and better from cold applications.
- Lieberthal AS, et al. The diagnosis and management of acute otitis media. Pediatrics, 2013, 131, 3, 964–99.
- Minovi A, Dazert S. Diseases of the middle ear in childhood. GMS current topics in otorhinolaryngology, Head and Neck Surgery. 2013, doi:10.3205/cto000114.
- Monasta L, et al. Burden of disease caused by otitis media: systematic review and global estimates..
PLOS ONE, 2012, 7 (4), doi:10/1371/journal.pone.0036226.
- Venekamp RP, et al. Antibiotics for acute otitis media in children.”. The Cochrane Database of Systematic Reviews, 2015, doi:10.1002/14651858.CD000219.pub4.
- Frei H, Thurneysen A. Homeopathy in Acute Otitis Media in Children: Treatment Effect or Spontaneous Resolution? British Homeopathic Journal, 2001, 90, 4, 180-2.
- Friese KH, et al. The Homoeopathic Treatment of Otitis Media in Children. International Journal of Clinical Pharmacology and Therapeutics, 1997, 35, 7, 96-301.
- Jacobs J, et al. Homeopathic treatment of acute otitis media in children: a preliminary randomized placebo-controlled trial. Pediatr Infect Dis J, 2001, 20, 2, 177-83.
- Sinha MN, et al. Randomized controlled pilot study to compare Homeopathy and Conventional therapy in Acute Otitis Media. Homeopathy. 2012, 101, 1, 5-12.
- Taylor JA, Jacobs J. Homeopathic Ear Drops As An Adjunct To Standard Therapy In Children With Acute Otitis Media. Homeopathy, 2011, 100, 109-115.