ENT sequence

“ENT Sequence”
Donald L. Allison, D.O.
Indications
Somatic dysfunction
Unusual because it is a sequence
URI
Allergy
Post head and neck procedures
General considerations
Work from central to peripheral
Break the dam
Encourage flow
Autonomics
Lymphatics
Biomechanics
POMA 106th Annual Clinical Assembly
April 30 – May 3, 2014
1
“ENT Sequence”
Donald L. Allison, D.O.
Autonomics
T1-T4
Rib raising
HVLA
MFR/ST
MET
Research
Henderson et al. “Effects of Rib Raising on the
Autonomic Nervous System: A Pilot Study Using
Noninvasive Biomarkers” J Am Osteopath Assoc.
2010;110(6):324-330
Rib raising salivary alpha amylase 76.2-46.0
(p=0.008)
Placebo salivary alpha amylase 83.4-71.5
(p=0.29)
Thoracic outlet
MFR
Direct
Indirect
BLT
Disengage
Exaggerate
Follow
POMA 106th Annual Clinical Assembly
April 30 – May 3, 2014
2
“ENT Sequence”
Donald L. Allison, D.O.
Anterior Cervical Arches
Articulatory technique
MFR
Direct
Indirect
BLT
Hyoid bone
BLT
HVLA
Position to barrier
Ask patient to swallow
Cervical lymphatic chains
Following SCM
Milking in Okazaki fragments
Gentle
Rhythmic
Careful of carotid massage
POMA 106th Annual Clinical Assembly
April 30 – May 3, 2014
3
“ENT Sequence”
Donald L. Allison, D.O.
Submandibular fossa
MFR
Direct
Indirect
Periauricular drainage
Spock hands
Gentle rhythmic circles
Until maximal therapeutic effect
Glabreath technique
Slow, rhythmic, gentle
Ipsilateral eustatian tube
Contralateral pterygoids?
POMA 106th Annual Clinical Assembly
April 30 – May 3, 2014
4
“ENT Sequence”
Donald L. Allison, D.O.
Nasal bone distration
Two holds
Thumbs on both sides
Articulate laterally
Caudad hand on nose, cephalad hand on frontal
Distract and articulate
Trigeminal nerve
Sensory and motor nerve
Direct gentle stimulation
All three divisions at once?
Facial effleurage
Gentle caress
Surface lymphatics
Central to peripheral
POMA 106th Annual Clinical Assembly
April 30 – May 3, 2014
5
“ENT Sequence”
Donald L. Allison, D.O.
Suboccipital release
Fingers under occiput
Gentle traction
Cephalad
Lateral
Hold until release is felt
Billing regions
Thorax (739.2)
Ribs (739.8)
Cervical (739.1)
Head (739.0)
Questions
POMA 106th Annual Clinical Assembly
April 30 – May 3, 2014
6

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