TY - JOUR
T1 - Effect of Water Precautions on Otorrhea Incidence after Pediatric Tympanostomy Tube
T2 - Randomized Controlled Trial Evidence
AU - Subtil, Joao
AU - Jardim, Ana
AU - Araujo, João
AU - Moreira, Carla
AU - Eµa, Tiago
AU - McMillan, Merlin
AU - Simoes Dias, Sara
AU - Vera Cruz, Paulo
AU - Voegels, Richard
AU - Paço, Joao
AU - Rosenfeld, Richard
PY - 2019
Y1 - 2019
N2 - Objectives: Tympanostomy with ventilation tube insertion is the most common otologic surgery. Many surgeons recommend water precautions, although its utility is questioned. We aimed to investigate if water precautions reduce the rate of otorrhea after transtympanic tube insertion. Study Design: Multicenter randomized controlled trial. Subjects and Methods: A total of 244 children aged 2 to 10 years undergoing their first set of Shepard tubes for otitis media with effusion and concomitant adenoidectomy were randomized to 2 groups: 1 with ear protection during water exposure (ear plugs and headbands, n = 130) and 1 without (n = 114). Bathing or swimming with unprotected ears was considered the exposure event and incidence of otorrhea, the primary outcome. Outcomes were assessed during the 6-month follow-up period. Results: In the water precaution group, 32% had at least 1 episode of otorrhea as compared with 22% in the unprotected group, which was not statistically significant (P =.09). Only 37% of the episodes of otorrhea in the protected group and 36% in the unprotected group had a temporal relation to water exposure (no difference, P =.81). Respectively, 56% and 52% of the episodes of otorrhea were in the context of upper respiratory tract infection. Global quality of life improved significantly, irrespective of whether water protection was prescribed. Conclusion: The incidence of otorrhea was not different with or without prescription of ear protection during water exposure among children with tympanostomy tubes, which supports current guideline recommendations that routine water precautions are unnecessary in this population.
AB - Objectives: Tympanostomy with ventilation tube insertion is the most common otologic surgery. Many surgeons recommend water precautions, although its utility is questioned. We aimed to investigate if water precautions reduce the rate of otorrhea after transtympanic tube insertion. Study Design: Multicenter randomized controlled trial. Subjects and Methods: A total of 244 children aged 2 to 10 years undergoing their first set of Shepard tubes for otitis media with effusion and concomitant adenoidectomy were randomized to 2 groups: 1 with ear protection during water exposure (ear plugs and headbands, n = 130) and 1 without (n = 114). Bathing or swimming with unprotected ears was considered the exposure event and incidence of otorrhea, the primary outcome. Outcomes were assessed during the 6-month follow-up period. Results: In the water precaution group, 32% had at least 1 episode of otorrhea as compared with 22% in the unprotected group, which was not statistically significant (P =.09). Only 37% of the episodes of otorrhea in the protected group and 36% in the unprotected group had a temporal relation to water exposure (no difference, P =.81). Respectively, 56% and 52% of the episodes of otorrhea were in the context of upper respiratory tract infection. Global quality of life improved significantly, irrespective of whether water protection was prescribed. Conclusion: The incidence of otorrhea was not different with or without prescription of ear protection during water exposure among children with tympanostomy tubes, which supports current guideline recommendations that routine water precautions are unnecessary in this population.
KW - middle ear ventilation
KW - otitis media with effusion
KW - postoperative care
KW - swimming
KW - water precautions
UR - http://www.scopus.com/inward/record.url?scp=85064665407&partnerID=8YFLogxK
U2 - 10.1177/0194599819844487
DO - 10.1177/0194599819844487
M3 - Article
C2 - 30987526
AN - SCOPUS:85064665407
SN - 0194-5998
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
ER -