Water precautions in children with tympanostomy tubes

To compare the effectiveness of antibiotic ear drops (suspension of polymyxin B sulfate, neomycin sulfate, and hydrocortisone [Pediotic]), prefabricated ear molds, or no precautions in decreasing the incidence of posttympanostomy water-related otorrhea.

Five-year prospective controlled study.

University referral center.

Five hundred thirty-three pediatric patients who were undergoing tympanostomy tube placement (including those who were undergoing tonsillectomy, adenoidectomy, or both) were self-selected into four groups.

The use of antibiotic ear drops that contained polymyxin B, neomycin, and hydrocortisone and the use of prefabricated ear molds. Group 1 comprised patients who were not given any water precautions with swimming regardless of the depth or type of water; group 2 comprised patients in whom antibiotic ear drops were applied after all forms of swimming; group 3 comprised patients who used ear molds with all forms of swimming (all children were advised against diving and swimming more than 180 cm below the surface, and parents were cautioned to avoid the entrance of soapy water into their child's ears during bathing); and group 4 comprised patients who were selected not to swim at all (they served as a control group).

No statistically significant difference was observed in the incidence of posttympanostomy swimming-related otorrhea among the three swimming groups (11%, 14%, and 20% of children in groups 1, 2, and 3, respectively, reported swimming-related otorrhea [P=.26, df-2, chi-square=2.66]). Children who did not swim at all (group 4) did not differ significantly in their overall incidence of otorrhea (59%) from the three swimming groups combined (68%) during the follow-up period (P=.11, df=1, chi-square=2.54).

Young children with tympanostomy tubes who surface swim and do not dive receive no additional benefit from the taking of water precautions in the form of earplugs or antibiotic ear drops.