Tympanostomy tubes and water exposure

A practical model

Richard L. Hebert, Geoffrey E. King, John P. Bent

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Objective: To determine whether water exposure causes middle ear contamination in patients with collar button tympanostomy tubes (TTs). Method and Design: An in vitro model of a human head that contained an auricle, external auditory canal, tympanic membrane with TT, middle ear, eustachian tube, and mastoid cavity was developed. Two electrodes connected to an external ohmmeter resided in the middle ear to detect water entry. The model was tested with 4 types of water exposure: showering, bathing, hair rinsing, and swimming. Statistical analysis was performed by the Fisher exact test. Main Outcome Measures: A positive test result corresponded to water entering the middle ear via the TT, confirmed by a resistance reading of zero on the ohmmeter. A negative test result indicated no change in the initial high resistance reading. Results: No positive test results were obtained for showering (0 of 60 tests), hair rinsing (0 of 60 tests), or head submersion (12.7 cm) in clean tap water (0 of 60 tests). Ten positive test results were obtained for head submersion in soapy water (10 of 97 tests), which was statistically different from clean water (P<.007). Swimming pool depths of 30, 45, 60, and 75 cm elicited positive test results in 2 of 16, 3 of 18, 2 of 20, and 11 of 20 tests, respectively. A higher incidence of water entry into the middle ear occurred at depths of more than 60 cm (P≤.001). No statistical difference between depths of 60 cm or less occurred (P = .88). Conclusions: Showering, hair rinsing, and head submersion in clean tap water do not promote water entry into the middle ear. Submersion in soapy water increases the probability of water contamination. Pool water infrequently enters the middle ear with head submersion, but the incidence increases with deeper swimming (>60 cm). These data provide further evidence that many water precautions frequently advised in patients with TTs are unnecessary.

Original languageEnglish (US)
Pages (from-to)1118-1121
Number of pages4
JournalArchives of Otolaryngology - Head and Neck Surgery
Volume124
Issue number10
StatePublished - Oct 1998
Externally publishedYes

Fingerprint

Middle Ear Ventilation
Water
Middle Ear
Head
Immersion
Hair
Reading
Eustachian Tube
Tympanic Membrane
Ear Canal
Mastoid
Electrodes
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Tympanostomy tubes and water exposure : A practical model. / Hebert, Richard L.; King, Geoffrey E.; Bent, John P.

In: Archives of Otolaryngology - Head and Neck Surgery, Vol. 124, No. 10, 10.1998, p. 1118-1121.

Research output: Contribution to journalArticle

Hebert, Richard L. ; King, Geoffrey E. ; Bent, John P. / Tympanostomy tubes and water exposure : A practical model. In: Archives of Otolaryngology - Head and Neck Surgery. 1998 ; Vol. 124, No. 10. pp. 1118-1121.
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abstract = "Objective: To determine whether water exposure causes middle ear contamination in patients with collar button tympanostomy tubes (TTs). Method and Design: An in vitro model of a human head that contained an auricle, external auditory canal, tympanic membrane with TT, middle ear, eustachian tube, and mastoid cavity was developed. Two electrodes connected to an external ohmmeter resided in the middle ear to detect water entry. The model was tested with 4 types of water exposure: showering, bathing, hair rinsing, and swimming. Statistical analysis was performed by the Fisher exact test. Main Outcome Measures: A positive test result corresponded to water entering the middle ear via the TT, confirmed by a resistance reading of zero on the ohmmeter. A negative test result indicated no change in the initial high resistance reading. Results: No positive test results were obtained for showering (0 of 60 tests), hair rinsing (0 of 60 tests), or head submersion (12.7 cm) in clean tap water (0 of 60 tests). Ten positive test results were obtained for head submersion in soapy water (10 of 97 tests), which was statistically different from clean water (P<.007). Swimming pool depths of 30, 45, 60, and 75 cm elicited positive test results in 2 of 16, 3 of 18, 2 of 20, and 11 of 20 tests, respectively. A higher incidence of water entry into the middle ear occurred at depths of more than 60 cm (P≤.001). No statistical difference between depths of 60 cm or less occurred (P = .88). Conclusions: Showering, hair rinsing, and head submersion in clean tap water do not promote water entry into the middle ear. Submersion in soapy water increases the probability of water contamination. Pool water infrequently enters the middle ear with head submersion, but the incidence increases with deeper swimming (>60 cm). These data provide further evidence that many water precautions frequently advised in patients with TTs are unnecessary.",
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