title: Efficacy of commercial earplugs in preventing water intrusion during swimming.
abstract: OBJECTIVE
  To evaluate and compare the efficacy of commercially available earplugs in preventing water intrusion in healthy individuals.
  
  
  METHODS
  Experimental study.
  
  
  METHODS
  Tertiary care medical center.
  
  
  METHODS
  Ten subjects (20 ears) were assessed. After insertion of the earplugs, subjects underwent 3 standardized head-wetting protocols, including (1) surface swimming for 10 minutes, which entailed no head submersion and moderate splashing; (2) head submersion at a 90-cm depth for 20 seconds with their head upright; and (3) head submersion at a 90-cm depth with head tilted 90 degrees left and then tilted 90 degrees right for 10 seconds on each side to apply vertical pressure. Color change of a wetness indicator was used to determine water intrusion after each protocol. The same protocol was repeated for all 9 earplugs.
  
  
  RESULTS
  Water intrusion was observed in 44%, 67%, and 88% of ears after surface swimming, horizontal submersion, and vertical submersion, respectively. The results revealed a significant difference in the waterproofing qualities of the various types of earplugs. The soft silicone type (Pillow Soft) earplug had the lowest rate of water penetration during all 3 protocols (P < .001). The difference between the most effective earplugs, Pillow Soft and Aquaseal, were only significant during the horizontal submersion protocol (P = .008).
  
  
  CONCLUSIONS
  Water intrusion occurred even with the use of earplugs. The intrusion was more significant with horizontal or vertical head submersion. The soft silicone Pillow Soft earplug was the most effective earplug for preventing water intrusion in surface swimming.
authors.affiliation: Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California 92868, USA.
authors.forename: Hossein
authors.initials: H
authors.lastname: Mahboubi
authors.forename: Austin
authors.initials: A
authors.lastname: Lee
authors.forename: Saman
authors.initials: S
authors.lastname: Kiumehr
authors.forename: Shawn
authors.initials: S
authors.lastname: Zardouz
authors.forename: Shawhin
authors.initials: S
authors.lastname: Shahriari
authors.forename: Hamid R
authors.initials: HR
authors.lastname: Djalilian
mesh_terms: D000293:Adolescent; D002648:Child; D004424:Ear Canal; D004430:Ear Protective Devices; D005260:Female; D006257:Head; D006801:Humans; D007101:Immersion; D008297:Male; D012828:Silicones; D013550:Swimming; D014867:Water; D055815:Young Adult
chemical_list: D012828:Silicones; D014867:Water