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Posttympanostomy Tube Water Precautions

James M. Poss, MD; Mark E. Boseley, MD; James V. Crawford, MD

Arch Otolaryngol Head Neck Surg. 2008;134(2):133-135.

Objectives  To determine what recommendations are given to patients or parents of patients with tympanostomy tubes regarding water exposure and to elucidate any recommendation differences between primary care and specialty care physicians.

Design  Clinical survey.

Setting  General community in the Pacific Northwest, including Washington, Oregon, and Idaho.

Participants  Physician surveys (N = 1116) were mailed to otolaryngologists, pediatricians, and family practitioners in the Pacific Northwest. Questions included what, if any, water precautions are given to patients or parents of patients who underwent tympanostomy tube insertion. Data were tabulated and compared among the 3 physician groups.

Main Outcome Measures  Recommendations regarding water exposure.

Results  A response rate of 23.5% (n = 263) was obtained. Most respondents were self-described otolaryngologists (n = 150) followed by family practitioners (n = 77) and pediatricians (n = 36). ² Analysis of the responses from each specialty group showed an overall significant difference about swimming precautions (P < .001). Further analysis of these data shows that many otolaryngologists (47% [n = 71]) and most primary care physicians (73% [n = 83]) recommend the use of barrier devices for swimming. Another 47% of otolaryngologist respondents allow swimming without any water precautions. With regard to depth of dive, there was no statistical significance found between the physician groups.

Conclusions  Recommendations for swimming precautions are not universal among the physician groups that routinely see patients with tympanostomy tubes. Most primary care physicians and many otolaryngologists continue to prescribe water precautions to patients or parents of patients with tympanostomy tubes, despite published articles that have shown no reduction in the incidence of otorrhea from the use of barrier devices or from the avoidance of swimming.

Author Affiliations: Department of Otolaryngology, Madigan Army Medical Center, Tacoma, Washington.