title: Water penetration into middle ear through ventilation tubes in children while swimming.
abstract: BACKGROUND
  Ventilation tube insertion is a common treatment for children with persistent otitis media with effusion. Parents are concerned about the morbidity of this procedure and the influence of ventilation tubes on daily activities. Permissibility of swimming is a question that is most often asked. The aim of this study was to investigate the possibility of water penetration through ventilation tubes into the middle ear while swimming in children with ventilation tubes under immediate observation.
  
  
  METHODS
  We included 14 patients who had otitis media with effusion who received ventilation tube insertion. They had complete ear, nose and throat physical examination. All 14 patients were taken to enjoy surface swimming for 1 hour without ear protection. Before and after swimming, we checked the tympanic membrane and external ear canal using a videotelescope and monitor immediately at the poolside to discover if there was fluid in the external ear canal and middle ear. Patients were followed-up 2 weeks later to check if otorrhea had occurred.
  
  
  RESULTS
  The 14 patients were from 5 to 14 years old. Nine were male and 5 were female. Nine patients had bilateral ventilation tubes and 5 had unilateral ones. One ear was excluded due to the tube nearly dropping out. A total of 22 ears were included. Eight ears were noted to be dry after swimming. Five ears were noted to have water over the outer 1 third of the external ear canal. Two ears were noted to have water over the inner 2 thirds of the external ear canal. Water on the tube or tympanic membrane was found in 6 ears. Only 1 ear with water penetration into the middle ear was found. No otorrhea had occurred in any ears after 2 weeks.
  
  
  CONCLUSIONS
  Water penetration into the middle ear through ventilation tubes and middle ear infection are not likely when surface swimming. Children with ventilation tubes can enjoy swimming without protection in clean chlorinated swimming pools.
authors.affiliation: Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Mao-Che
authors.initials: MC
authors.lastname: Wang
authors.forename: Chia-Yu
authors.initials: CY
authors.lastname: Liu
authors.forename: An-Suey
authors.initials: AS
authors.lastname: Shiao
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation / Q000009:adverse effects; D010034:Otitis Media with Effusion / Q000175:diagnosis / Q000601:surgery*; D013550:Swimming