Water protection in paediatric patients with ventilation tubes: Myth or reality? A systematic review.
Bathing
Bañarse
Drenajes timpánicos
Ducharse
Ear protective device
Grommets
Natación
Precauciones con el agua
Showering
Swimming
Tapones de protección auditiva
Tubos de ventilación
Tubos transtimpánicos
Tympanostomy tube
Ventilation tubes
Water precautions
Journal
Acta otorrinolaringologica espanola
ISSN: 2173-5735
Titre abrégé: Acta Otorrinolaringol Esp (Engl Ed)
Pays: Spain
ID NLM: 101770938
Informations de publication
Date de publication:
16 Aug 2021
16 Aug 2021
Historique:
received:
29
03
2021
revised:
26
05
2021
accepted:
31
05
2021
entrez:
20
8
2021
pubmed:
21
8
2021
medline:
21
8
2021
Statut:
aheadofprint
Résumé
Myringotomy with ventilation tube (VT) insertion is one the most performed procedures in children and adolescents worldwide. VTs usually remain in the eardrum between 6 and 12 months and during this period otorrhoea is the most frequent complication. For years, parents have been advised to protect the ears of children with VTs from contact with water, as water exposure in the middle ear is likely to cause acute otitis media. However, there is a growing evidence that water should not traverse VTs unless under significant pressure, so routine water precautions should not be prescribed. Despite these recommendations, many otolaryngologists and paediatricians continue to prescribe earplugs during bathing or swimming or advise against aquatic activities. There are already two reviews in the current literature on this topic: the first used strict selection criteria and included only 2 high-quality studies, while the second presented evidence up to 2005. The aim of this review is to identify, summarize and critically appraise the current evidence concerning water precautions for children with VTs. Two independent reviewers separately searched for related scientific papers. A qualitative synthesis analysis was performed considering the selected studies regarding the effects of water exposure on paediatric subjects with VTs. Four randomized clinical trials (RCT) and five prospective cohort studies were included, for a total of 1299 patients aged from 3 months to 14 years. No statistically significant difference in otorrhoea incidence between water exposure with and without ear protection in children with VTs, and between water exposure and no water exposure in children with VTs, was found. Therefore avoiding water is at best inconvenient and at worst may delay learning to swim. The decision to protect the ear when exposed to water should be individualized and protection should be recommended during the first month after surgery and in cases of recurrent otorrhoea. Based on the literature available, allowing water surface activities with no ear protection seems to present a minimum risk, so it is not necessary to prohibit patients from swimming. However, some recommendations should be followed.
Sections du résumé
BACKGROUND
BACKGROUND
Myringotomy with ventilation tube (VT) insertion is one the most performed procedures in children and adolescents worldwide. VTs usually remain in the eardrum between 6 and 12 months and during this period otorrhoea is the most frequent complication. For years, parents have been advised to protect the ears of children with VTs from contact with water, as water exposure in the middle ear is likely to cause acute otitis media. However, there is a growing evidence that water should not traverse VTs unless under significant pressure, so routine water precautions should not be prescribed. Despite these recommendations, many otolaryngologists and paediatricians continue to prescribe earplugs during bathing or swimming or advise against aquatic activities. There are already two reviews in the current literature on this topic: the first used strict selection criteria and included only 2 high-quality studies, while the second presented evidence up to 2005. The aim of this review is to identify, summarize and critically appraise the current evidence concerning water precautions for children with VTs.
METHODS
METHODS
Two independent reviewers separately searched for related scientific papers. A qualitative synthesis analysis was performed considering the selected studies regarding the effects of water exposure on paediatric subjects with VTs.
RESULTS
RESULTS
Four randomized clinical trials (RCT) and five prospective cohort studies were included, for a total of 1299 patients aged from 3 months to 14 years. No statistically significant difference in otorrhoea incidence between water exposure with and without ear protection in children with VTs, and between water exposure and no water exposure in children with VTs, was found. Therefore avoiding water is at best inconvenient and at worst may delay learning to swim. The decision to protect the ear when exposed to water should be individualized and protection should be recommended during the first month after surgery and in cases of recurrent otorrhoea.
CONCLUSION
CONCLUSIONS
Based on the literature available, allowing water surface activities with no ear protection seems to present a minimum risk, so it is not necessary to prohibit patients from swimming. However, some recommendations should be followed.
Identifiants
pubmed: 34412895
pii: S0001-6519(21)00093-5
doi: 10.1016/j.otorri.2021.05.006
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
spa
Informations de copyright
Copyright © 2021 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.