WATER PRECAUTIONS AND TYMPANOSTOMY TUBES

传统上建议患有鼓膜造瘘管的儿童在游泳和洗澡时保护他们的耳朵。虽然急性耳漏通过未闭管是常见的，没有公开的证据表明水暴露是致病的。我们将前瞻性地随机抽取300名6个月至6岁的儿童，他们在一个月内接受了双侧鼓室造口管置入，并将他们分为两组：1)不戴耳塞游泳和洗澡，或2)戴耳塞游泳和洗澡。我们将根据年龄（<4岁，bb0 - 4岁）和诊断（复发性急性中耳炎，中耳炎伴积液）进行分组。家长将得到一个日历，记录所有的游泳和洗澡活动。在一年的时间里，孩子们每月都要去看一次，每当他们同时出现耳、鼻或喉咙问题时。如果出现耳漏，将进行培养，并用口服抗生素和耳局部滴剂治疗。第一个比较是每个实验组耳漏的发生率，第二个比较是两组中每个孩子的平均发作次数。检查培养结果将有助于确定耳漏的致病机制。

Children with tympanostomy tubes have traditionally been advised to protect their ears when swimming and bathing. Although acute otorrhea through a patent tube is a common occurrence, there is no published evidence that water exposure is causative. We will prospectively randomize 300 children, ages 6 months to 6 years, who have had bilateral tympanostomy tubes placed within one month of entry to one of 2 groups: 1) swimming and bathing without earplugs or 2) swimming and bathing with earplugs. We will stratify the groups by age (<4 years, > 4 years) and by diagnosis (recurrent acute otitis media, otitis media with effusion). Parents will be given a calendar to record all swimming and bathing activity. The children will be seen monthly for one year, and whenever there is an intercurrent ear, nose, or throat problem. If otorrhea develops, a culture will be performed and the child will be treated with an oral antibiotic and ototopical drops. The primary comparison will be the incidence of otorrhea in each experimental group and the second comparison will be the average number of episodes per child in the two groups. Examination of the culture results will help determine the pathogenic mechanisms responsible for the otorrhea.