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Editor's Note: This reprint of the September 2021 article Conductive Hearing Loss: A Case Report; Figure 2 was erroneously ommited from the original article and is now included alongside Figure 1 for appropriate context. AAO sincerely apologizes for the omission of the second figure in the original publication of this article.

Eye pain and ringing in the ear are non-specific symptoms commonly evaluated by primary care physicians and specialists alike. The differential diagnosis for these symptoms is broad and includes musculoskeletal, ophthalmologic and neurologic considerations. Careful consideration of the differential diagnosis should include acute, potentially life-threatening pathologies such as glaucoma or intracranial masses, as well as common pathologies, including cervicalgia, headache variants (migraine, tension) and acoustic neuroma. This report describes a patient with eye pain caused by occipital neuralgia and tinnitus. Correcting the somatic dysfunctions found in the head, cervical, thoracic and rib regions with osteopathic manipulative treatment resolved the occipital neuralgia and the tinnitus for this patient. Thus, osteopathic manipulative treatment should be considered for conservative management of occipital neuralgia and tinnitus.

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.

Iliotibial band friction syndrome (ITBFS) is one of the most common causes of lateral knee pain in athletes.1,2 Conservative management has been with ice, modified activity, stretching, nonsteroidal anti-inflammatories (NSAIDs), and/or corticosteroid injections.3–6 This treatment regimen has been effective in most, but not all.3,7 This report describes a patient with chronic lateral knee pain caused by ITBFS unresolved with both conservative and surgical management. The patient presented with multiple lower extremity dysfunctions, and correcting these dysfunctions resolved the lateral knee pain. Therefore, osteopathic manipulative treatment applied to the lower extremity is a valid consideration for conservative management of lateral knee pain caused by ITBFS.

After arthroscopic meniscectomy, it is important to ensure each patient regains as much of the original function of the knee as possible. The inherent structural and functional relationships among the bones, muscles, fascias, and lymphatics are vital. Each element should be a focus of treatment to reap maximum benefits and reduce long-term dysfunction. While increased range of motion and strengthening exercises are the current focus of postoperative rehabilitation, a more direct approach to the fascial and lymphatic systems should be instituted for those patients reporting swelling as a long-term sequela. In this case report, osteopathic manipulative treatment reduced recovery time for a 65-year-old woman following arthroscopic meniscectomy.

ObjectiveThis study retrospectively evaluated the effect of OMT on length of stay (LOS) in hospitalized posterolateral postthoracotomy patients.MethodsInpatient medical records of patients who received posterolateral thoracotomies with lung resection between 1998 and 2011 were reviewed for demographic data, LOS, thoracotomy surgery data, consultation data excluding osteopathic manipulative medicine, discharge data, and osteopathic manipulative medicine consultation data.ResultsThirty-eight patients received posterolateral thoracotomies with lung resection; 23 patients received OMT and 15 did not. The mean (standard deviation) LOS was 11.0 (6.8) days (range, 5–29 days) for those who received OMT and 10.4 (5.5) days (range, 3–22 days) for those who did not (P = .90). Five patients developed postoperative ileus, and all had received OMT. Patients receiving 2 surgical procedures had a longer LOS than those receiving 1 surgical procedure (P = .002). Having a decortication performed during the thoracotomy increased LOS by a mean of 6.4 days (P = .005). Patients admitted directly to the intensive care unit were more likely to receive OMT than those who were not (P = .03).ConclusionWhile there was no difference in LOS, severity of illness was different between patients who received OMT and those who did not. Patients who developed postoperative ileus and most of those admitted directly to the intensive care unit received OMT, suggesting that severity of illness was greater for those who received OMT. Future studies should include a higher subject number in order to stratify for illness severity and also assess the effect of OMT on postoperative pain.

Context: In the first half of the 20th century, nearly all osteopathic physicians used osteopathic manipulative medicine (OMM) in the care of hospitalized patients. Over the past few decades, however, inpatient OMM care has declined and is more commonly provided by OMM specialists. Objective: To retrospectively evaluate the details of a specialty-level OMM inpatient consultation service. Methods: Inpatient OMM consultations that took place at Northeast Regional Medical Center in Kirksville, Missouri, between July 1998 and March 2008 were identified from billing records. Consultations were reviewed for demographic information, admission location, postoperative status, intensive care unit and mechanical ventilation usage, admission and discharge diagnoses, consultation reasons and final diagnoses, areas of somatic dysfunction treated and types of osteopathic manipulative treatment (OMT) techniques used, and hospital length of stay (LOS). Results: A total of 1509 OMM consultations were identified (580 for male patients [38%]; 929 for female patients [62%]; mean [SD] age, 54 [31] years [range, 0-99 years]), representing 11% of all inpatient consultations. Of these, 1372 consultations (91%) were initiated in the inpatient acute care facility, 87 (6%) in the inpatient acute rehabilitation facility, and 50 (3%) in the skilled nursing facility. Further, 265 consultations (18%) were for postoperative patients, 187 (12%) were for patients in the intensive care unit, and 54 (4%) were for patients receiving mechanical ventilation at the time of the consultation. The most common admission diagnoses were hypertension, routine newborn care, lower respiratory infection, chronic obstructive pulmonary disease, and gastrointestinal symptoms. The most common reasons for OMM consultation were chest/rib pain, spinal pain, lower respiratory infection (adjunctive treatment), cranial asymmetry, and infant feeding disorder. The most common types of OMT techniques used were myofascial release, balanced ligamentous tension, muscle energy, soft tissue, and inhibition. The mean (SD) LOS was 5.7 (3.3) days (range, 0-48 days), while the mean (SD) number of days the patient received OMT was 3.1 (2.2) days. Conclusion: Medical records reviewed in the current study revealed that OMM consultations were ordered primarily for musculoskeletal complaints, respiratory problems (adjunctive treatment), and newborn care. A variety of OMT techniques were used. Further retrospective study is warranted to determine if OMM had an effect on LOS.