WATER PRECAUTIONS IN CHILDREN WITH TYMPANOSTOMY TUBES

Objective: To compare the effectiveness of antibiotic ear drops (suspe nsion of polymyxin B sulfate, neomycin sulfate, and hydrocortisone [Pe diotic]), prefabricated ear molds, or no precautions in decreasing the incidence of posttympanostomy water-related otorrhea. Design: Five-ye ar prospective controlled study. Setting: University referral center. Patients: Five hundred thirty-three pediatric patients who were underg oing tympanostomy tube placement (including those who were undergoing tonsillectomy, adenoidectomy, or both) were self-selected into four gr oups. Interventions: The use of antibiotic ear drops that contained po lymyxin B, neomycin, and hydrocortisone and the use of prefabricated e ar molds. Group 1 comprised patients who were not given any water prec autions with swimming regardless of the depth or type of water; group 2 comprised patients in whom antibiotic ear drops were applied after a ll forms of swimming; group 3 comprised patients who used ear molds wi th all forms of swimming (all children were advised against diving and swimming more than 180 cm below the surface, and parents were caution ed to avoid the entrance of soapy water into their child's ears during bathing); and group 4 comprised patients who were selected not to swi m at all (they served as a control group). Results: No statistically s ignificant difference was observed in the incidence of posttympanostom y swimming-related otorrhea among the three swimming groups (11%, 14%, and 20% of children in groups 1, 2, and 3, respectively, reported swi mming-related otorrhea [P=.26, df=2, X(2)=2.66]). Children who did not swim at all (group 4) did not differ significantly in their overall i ncidence of otorrhea (59%) from the three swimming groups combined (68 %) during the follow-up period (P=.11, df=1, X(2)=2.54). Conclusion: Y oung 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.