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Related Experiment Videos

Tympanostomy tubes and water exposure: a practical model

R L Hebert1, G E King, J P Bent

  • 1Division of Otolaryngology, Medical College of Georgia, Augusta, USA. RLHII@msn.co

Archives of Otolaryngology--Head & Neck Surgery
|October 17, 1998
PubMed
Summary

Water exposure does not contaminate the middle ear in patients with tympanostomy tubes (TTs) during showering, hair rinsing, or clean water submersion. Soapy water and deeper swimming increase contamination risk.

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Area of Science:

  • Otolaryngology
  • Biomedical Engineering
  • Infectious Disease Prevention

Background:

  • Tympanostomy tubes (TTs) are commonly placed to manage middle ear conditions.
  • Water exposure is often restricted for patients with TTs due to concerns about middle ear contamination.
  • Evidence-based guidelines for water precautions in patients with TTs are needed.

Purpose of the Study:

  • To investigate the risk of middle ear contamination through tympanostomy tubes (TTs) during various water exposure scenarios.
  • To determine if common water activities like showering, bathing, hair rinsing, and swimming lead to middle ear entry.
  • To provide data to inform water precaution recommendations for individuals with TTs.

Main Methods:

  • An in vitro human head model was utilized, featuring an intact ear canal, tympanic membrane with a TT, and simulated middle ear, eustachian tube, and mastoid.

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  • Water entry into the middle ear was detected using an ohmmeter connected to electrodes placed within the middle ear space.
  • The model was subjected to simulated showering, bathing, hair rinsing, and swimming at various depths and water conditions (clean vs. soapy).

    • Main Results:

    • No middle ear contamination was observed during simulated showering, hair rinsing, or head submersion in clean tap water.
    • Head submersion in soapy water resulted in a statistically significant increase in middle ear contamination.
    • Swimming in pool water showed infrequent middle ear entry at depths up to 60 cm, with a significant increase in contamination incidence at depths greater than 60 cm.

    Conclusions:

    • Showering, hair rinsing, and submersion in clean water do not pose a significant risk for middle ear contamination in patients with tympanostomy tubes (TTs).
    • The use of soapy water and swimming at depths exceeding 60 cm increases the likelihood of middle ear contamination.
    • Many commonly advised water precautions for patients with TTs may be unnecessary, suggesting a need to revise patient counseling based on these findings.