GROMMETS, SWIMMING AND OTORRHEA - A REVIEW

Ever since Armstrong reintroduced the concept of grommet insertion par ents have been asking 'may my child swim?', yet there is still no cons ensus as to the correct answer. This paper reviews the work that has b een done on this subject in the last 25 years. A review of the rates o f otorrhoea following grommet insertion, irrespective of swimming, sho ws a variation from 12 to 64 per cent. Evidence suggests that pressure s of 12-23 cm H2O are needed to push water through a grommet and that it is unlikely that water will enter the middle ear during surface swi mming. Only bath water seems to cause significant inflammatory changes to middle ear mucosa. Not a single paper comparing swimmers with non- swimmers shows an increased rate of otorrhoea in those patients who sw am; to the contrary, rates of otorrhoea were repeatedly higher in thos e patients who did not swim. The evidence suggests that swimming witho ut ear protection can be safely permitted for children with grommets.