title: Ventilation tubes after surgery for otitis media with effusion or acute otitis media and swimming. Systematic review and meta-analysis.
abstract: OBJECTIVE
  To determine if the use of ear protection when swimming of children with ventilation tubes modifies the risk of acute otitis media (AOM) compared to not swimming.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  Search conducted in MEDLINE, EMBASE and The Cochrane Library databases.
  
  
  METHODS
  Prospective cohort studies and controlled clinical trials of children with ventilation tubes, with a minimum follow-up of 2 months.
  
  
  METHODS
  Two reviewers independently assessed trial quality and extracted data.
  
  
  RESULTS
  11 studies were selected. No difference was found in risk of AOM in children who swim without ear protection compared with those who do not swim: Odds ratio=0.78, 95% confidence interval 0.42-1.44; nor compared with those who use earplugs and swimming caps, odds ratio=0.75, 95% confidence interval 0.38-1.48; nor in those who use ear drops after swimming compared with those who used earplugs or swimming caps, odds ratio=0.76, 95% confidence interval 0.56 to 1.02. The use of ear drops after swimming increases the risk of AOM in children with ventilation tubes as compared with those who do not swim, odds ratio=3.14, 95% confidence interval 1.40 to 7.05.
  
  
  CONCLUSIONS
  There is no evidence to suggest that protection when swimming with earplugs, swimming caps or ear drops in children with ventilation tubes reduces the risk of AOM. Ear drops may even increase this risk.
authors.affiliation: ENT Department, Hospital de Sagunto, Regional Health Authority, Avda. Ramón y Cajal s/n, 46520 Sagunto, Valencia, Spain. carbonell_raf@gva.es
authors.forename: Rafael
authors.initials: R
authors.lastname: Carbonell
authors.forename: Vicente
authors.initials: V
authors.lastname: Ruíz-García
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D004430:Ear Protective Devices / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation / Q000295:instrumentation* / Q000379:methods; D016017:Odds Ratio; D010033:Otitis Media / Q000175:diagnosis / Q000601:surgery*; D010034:Otitis Media with Effusion / Q000175:diagnosis / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control*; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention; D012680:Sensitivity and Specificity; D013550:Swimming