ABC of ENT. Deafness in childhood.

Ludman, Harold

doi:10.1136/bmj.282.6261.381

Cited by 5 publications

(7 citation statements)

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“…An article in the BMJ published anonymously in 1978 (Anon, 1978) advised that children with grommets should not swim. In 1981, Ludman (1981 gave similar advice. In 1993 Pringle published a review of published work on the evidence for otorrhoea caused by swimming in children with grommets.…”

Section: Introductionmentioning

confidence: 76%

British Association for Paediatric Otorhinolaryngology (BAPO) Abstracts from meeting 3 July 1999

1999

J. Laryngol. Otol.

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Section: Introductionmentioning

confidence: 76%

British Association for Paediatric Otorhinolaryngology (BAPO) Abstracts from meeting 3 July 1999

1999

J. Laryngol. Otol.

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“…The advice not to swim is based on the theoretical assumption that water will pass through the grommet into the middle ear and cause a suppurative otitis media. Ten years ago the general advice was that children with grommets should not swim (Anon, 1978;Ludman, 1981) or should use ear plugs and a 'tight bathing cap' (Gibb, 1979). Some even went as far as to recommend removal of the grommets during the summer months (Gibb, 1979).…”

Section: Introductionmentioning

confidence: 99%

“…Despite the evidence, advice is still given that children with grommets should not swim (Ludman, 1988). This article reviews all the work that has been done in the last 25 years in relation to grommets, ear discharge (otorrhoea) and swimming and presents the findings.…”

Section: Introductionmentioning

confidence: 99%

Grommets, swimming and otorrhoea — a review

Pringle¹

1993

J. Laryngol. Otol.

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Ever since Armstrong reintroduced the concept co grommeet insertion parents have been asking ‘may my child swim?’, yet there is still no consensus as to the correct answer. This paper reviews the work that has been done on this subject in the last 25 years. A review of teh reates of otorrhoea following grommet insertion, irrespective of swimming, shows a variation from 12 to 64 per cent. Evidence suggests that pressures of 12–23 cm H2O are needed to push water through a grommeet and that it is unlikely that water will enter the middle ear during surface swimming. Only bath water seems to cause significant inflammtory changes to middle ear mucosa. Not a single paper comparing swimming without ear protection can be safely permitted for children with grommets.

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“…It is characterised by an abnormal appearance of the eardrum, which may be coloured grey, yellow or blue, and mild to moderate conductive hearing loss, and is not associated with fever. Otitis media with effusion may also be known as 'serous', 'secretory' or 'suppurative otitis media', 'middle ear effusion' or 'glue ear' [7,14,22,56,[87][88][89][90][91][92][93].…”

Section: Otitis Media With Effusionmentioning

confidence: 99%

“…The presence of fluid (i.e. pus) in the middle ear leads to conductive deafness [53,56,57,[87][88][89][90][91][92].…”

Section: Acute Otitis Mediamentioning

confidence: 99%

Parental Smoking and Middle Ear Disease in Children: A Review of the Evidence

Thornton

1999

Indoor Built Environ

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This report presents a detailed review of the available epidemiological evidence concerning the prevalence of middle ear infections in children in relation to their exposure to smoking by their parents or other household members and is based on English-language papers covering the period 1979–1998. Fifty-eight studies are included in the review, with the most widely used index of exposure being parental smoking. Smoking by all household members, by either parent separately and by the mother during pregnancy were also considered in some of the studies. Only 3 studies attempted to quantify exposure objectively, using measurements of cotinine and nicotine in hair, saliva and pericardial fluid. Tables listing unadjusted and adjusted relative risk estimates were constructed for both postnatal exposure to tobacco smoke and for maternal smoking during pregnancy. The results for postnatal exposure were separated into five disease categories. The overall data suggested some association of postnatal exposure to tobacco smoke with three categories; recurrent otitis media, otitis media with effusion and unspecified middle ear disease, with risk tending to increase with increasing exposure, but no association with acute otitis media or with persistent otitis media with effusion. However, reported associations were generally quite weak, with relative risks typically below 1.5. Problems in interpreting the data arise from the difficulty of distinguishing possible effects of environmental tobacco smoke and of maternal smoking during pregnancy (for which the data also suggest an association), the possibility that the underlying cause of middle ear disease is in fact an infection, and from the various possibilities of bias inherent in epidemiological studies of a weak association, particularly due to inadequate control of confounding. Though it is prudent for parents not to expose their children to high doses of environmental tobacco smoke for long periods, the overall epidemiological evidence does not convincingly demonstrate that exposure to environmental tobacco smoke increases the incidence of middle ear diseases in children.

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ABC of ENT. Deafness in childhood.

Cited by 5 publications

References 0 publications

British Association for Paediatric Otorhinolaryngology (BAPO) Abstracts from meeting 3 July 1999

British Association for Paediatric Otorhinolaryngology (BAPO) Abstracts from meeting 3 July 1999

Grommets, swimming and otorrhoea — a review

Parental Smoking and Middle Ear Disease in Children: A Review of the Evidence

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