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Other studies using CT scans of a pediatric population showed no passive opening of tympanostomy tubes or flow during modeling of submersion. Another study with a recreated model of the auditory system showed that soapy water required the lowest hydrostatic pressure to penetrate the middle ear. However, it did show presence of water in the middle ear when the model was submerged in soapy water (10.3% soap) and an increase in penetration with increasing depth. One study using acrylic and rubber models of human heads showed that penetration of water into the middle ear was not seen with showering, hair rinsing or submersion in 13 cm of tap water.
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In the same study, it was found that only 17.6% of websites meeting study criteria advised against water precautions, as did only 4.4% of hospital leaflets.ĭifferent in-vitro studies have been conducted to determine whether water is able to penetrate through the tympanostomy tubes. In another survey of clinicians, only about 10% of respondents recommended no routine precautions. In a survey of providers of different levels and specialties, it was found that 47% of otolaryngologists that responded recommended use of barrier devices for swimming.
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Historically, there has been differing opinions on the appropriate water precautions recommended after tympanostomy tube placement. This prompted many physicians to recommend water precautions such as avoidance of submersion of head in water or use of occlusive ear plugs.Ĭurrently, routine water precautions are not supported by the American Academy of Otolaryngology- Head and Neck Surgery (AAOHNS).
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The frequency of otorrhea in the tympanostomy tube population was once partially attributed to water penetrating into the middle ear through the tympanostomy tube. A large cohort study in 2013 found that 52% of children experienced one of more episodes of otorrhea after tympanostomy tube placement, with 12% of the total cohort experiencing recurrent episodes of otorrhea. One of the most common complications that is associated with placement of tympanostomy tubes is otorrhea. It is estimated that about 7% of children in the United States will have tympanostomy tubes inserted by 3 years of age.
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Common indications for tympanostomy tube placement include chronic or recurrent otitis media with effusion (OME), recurrent acute otitis media (AOM), or infections that are refractory to antibiotic therapy. Myringotomy with tympanostomy tube placement is the most common ambulatory surgery performed in children in the United States.
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