WATER PRECAUTIONS AND TYMPANOSTOMY TUBES

传统上，建议带鼓膜管的儿童在游泳和洗澡时保护耳朵。 虽然急性耳鼻喉通过一个专利管是一种常见的事件，有没有公布的证据表明，水暴露是病因。 我们将前瞻性随机选择300名6个月至6岁的儿童，他们在入院后一个月内放置了双侧鼓膜造口管，分为两组：1）游泳和洗澡时不戴耳塞，或2）游泳和洗澡时戴耳塞。 我们将根据年龄（<4岁，> 4岁）和诊断（复发性急性中耳炎，渗出性中耳炎）对各组进行分层。 父母将得到一个日历，记录所有游泳和洗澡活动。 孩子们将每月看一次，持续一年，每当有并发的耳，鼻或喉咙问题。 如果耳炎发展，将进行文化和儿童将与口服抗生素和耳局部滴剂治疗。 主要比较将是每个实验组中耳畸形的发生率，第二次比较将是两组中每个儿童的平均发作次数。 检查培养结果将有助于确定耳畸形的致病机制。

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.