By Brittany Whitlock, Au.D., CCC-A

Did you know that tympanostomy tube placement is the most common surgery performed on children in the United States? It is estimated that by the age of three, one in 15 children will undergo tube placement for treatment of recurrent ear infections, persistent middle ear fluid, and Eustachian tube dysfunction (Kogan, 2000). Children under the age of seven are at a higher risk for these medical issues due to their immature immune system and poor functioning of the Eustachian tube, (the ventilation tube located between the middle ear and the back of the throat) which equalizes pressure with the outside environment.

Despite tube placement, some children continue to experience middle ear infections. A study performed in 2001 revealed that although tube placement lowers the instance of ear infections, approximately 15-26% of children will continue to experience episodes following surgery (Kay, 2001).

A common symptom associated with middle ear infections following tube placement is logorrhea, or discharge from the middle ear space through a functioning tube into the ear canal. While otorrhea is usually painless, it should be treated promptly by your otolaryngologist. Otorrhea may be caused by water contamination in the middle ear; prevention can be achieved by taking appropriate water precautions.

Swimming is a favorite summer activity for many children; however, if a child has tympanostomy tubes, it can cause parental concern and anxiety. Some of the most common questions a parent asks after surgery are “Can my child swim in the pool?” and “Can I get my child’s ears wet during bath time?”

Often children will report pain when water enters their ears following tube placement. The use of earplugs and swim bands may be warranted to achieve a comfortable experience during swimming and bathing and is useful in preventing future episodes of otorrhea.

Ear plugs are used to seal the external ear and prevent water from entering the ear canal, and potentially, the middle ear through a functioning tube. Different types of ear plugs are available and are appropriate to use in a variety of water environments, including swimming pools, lakes, oceans, and baths.

Parents should be aware of the different types of water environments which are appropriate for children with tubes. Chlorinated swimming pools are the least risky water environment, especially if a child is only “surface swimming”; however, ear plugs are still recommended if a child complains of ear pain or if they are diving or swimming more than one foot below the surface of the water.

Conversely, dirty water environments, such as lakes oceans and baths, are instances when ear plugs are absolutely recommended to prevent water contamination of the middle ear space.

Numerous studies have shown that head submersion in soapy water during bath time increases the probability of water passing through the tube and causing contamination, ear pain, or otorrhea (Hebert 2013, Pashley 1984).

For Your Convenience

Two types of ear plugs are available for purchase at all PENTA locations. First, Doc’s Pro Plugs are hypo-allergenic swim plugs that provide a watertight seal during water activities. They are pre-sized and are available in pink or blue.

In order to purchase Doc’s Pro Plugs, the child’s ear will need to be sized by an audiologist at PENTA to ensure an appropriate fit. Younger children who are mostly “surface swimmers” and aren’t as adventurous in the water usually find the Doc’s Pro Plugs a suitable choice for water protection. Often, older children who dive or swim more than one foot below the surface of the water require a more advanced form of water protection.

Custom ear plugs are usually successful in keeping an older, more active child’s ear dry during swimming. ‘

  • Custom ear plugs are made of silicone material and create an exact replica of a child’s ear.
  • An impression is taken of the child’s ear and is sent to the manufacturer for processing.
  • A variety of color options are available including neon colors, stripes, polka dots, and multiple colors swirled together for a more personal feel.

An additional water precaution available is a Swim Band-It; a neoprene headband which is fully-adjustable with a Velcro closure, and is available is several sizes and colors. The Swim Band-It can be used in conjunction with ear plugs for better retention during swimming.

Please contact PENTA audiology at (404) 591-1884 for pricing information for each of these items.

Tube placement can be a great relief for families from the stress caused by frequent ear infections in a young child, but it can also be a source of anxiety and questions when it comes to swimming and taking water precautions. If parents take the correct steps to prevent water contamination, their children can enjoy all the benefits of water activities without the pain or worry about future ear infections.