Water precautions for prevention of infection in children with ventilation tubes (grommets)

Moualed, Daniel; Masterson, Liam; Kumar, Sanjiv; Donnelly, Neil

doi:10.1002/14651858.cd010375.pub2

Cited by 24 publications

(28 citation statements)

References 23 publications

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“…Information concerning water precautions was most variable, with three websites suggesting that ear plugs may need to be used and two websites providing no mention of water precautions. A systematic review of randomized controlled trials regarding the effectiveness of water precautions in preventing ear infections showed no clinical significant decrease in ear infections when water precautions were taken . These findings are not indicative of physician compliance but may provide a starting point to evaluate CPG adherence in clinical practice and standardization of practice.…”

Section: Discussionmentioning

confidence: 99%

Consulting Dr. Google: Quality of Online Resources About Tympanostomy Tube Placement

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Consulting Dr. Google: Quality of Online Resources About Tympanostomy Tube Placement

et al. 2017

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“…There is no strong evidence for universal water precautions. 59 A small RCT showed no difference in otorrhoea in Australian Aboriginal children who swam daily in a chlorinated pool. 60 Referral to an ENT specialist is recommended in cases where there is significant hearing loss or frequent recurrent active disease.…”

Section: Dry Perforationmentioning

confidence: 99%

Preventative and medical treatment of ear disease in remote or resource-constrained environments

et al. 2019

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BackgroundImportant ear problems can affect the outer ear, the middle ear and the inner ear. Globally, the greatest burden of disease is due to ear conditions that are associated with otorrhoea and hearing loss.MethodsThis study reviewed the literature on the prevention and treatment of common ear conditions that are most relevant to settings with high rates of ear disease and limited resources. The grading of recommendations assessment, development and evaluation (‘GRADE’) approach was utilised to assess interventions.ResultsAccurate diagnosis of ear disease is challenging. Much of the preventable burden of ear disease is associated with otitis media. Nine otitis media interventions for which there is moderate to high certainty of effect were identified. While most interventions only provide modest benefit, the impact of treatment is more substantial in children with acute otitis media with perforation and chronic suppurative otitis media.ConclusionDisease prevention through good hygiene practices, breastfeeding, reducing smoke exposure, immunisation and limiting noise exposure is recommended. Children with acute otitis media with perforation, chronic suppurative otitis media, complications of otitis media, and significant hearing loss should be prioritised for medical treatment.

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“…OME is one of the most common conditions affecting all children. It has been the subject of large number of clinical trials and systematic reviews (Table ) . Accurate incidence and prevalence data are difficult to attain (because OME may be present for short periods then resolve spontaneously).…”

Section: Ent Responsementioning

confidence: 99%

“…The major inconvenience is that the grommet exposes the middle ear to the outside environment. This means that the ears should be kept dry to reduce the risk of discharge . Some surgeons may advocate incising the tympanic membrane and removing the effusion (myringotomy) together with an adenoidectomy (without inserting a grommet).…”

Section: What Is the Role For Tympanostomy Tube Surgery?mentioning

confidence: 99%

“…The surgeon will frequently prescribe ciprofloxacin‐based ear drops for 3–5 days after the operation as this has been shown to reduce the risk of continuing discharge from the ear after the procedure . After the surgery, keeping water out of the ears to prevent aural discharge is usually recommended . Simple measures, like obtaining some ear plugs or placing some Vaseline on cotton wool at bath time, will usually suffice.…”

Section: What Is the Role For Tympanostomy Tube Surgery?mentioning

confidence: 99%

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Ear, nose and throat surgery: All you need to know about the surgical approach to the management of middle‐ear effusions in Australian Indigenous and non‐Indigenous children

Kong

Lannigan

Morris

et al. 2017

J Paediatrics Child Health

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Otitis media (OM) is a common condition in Australia. It represents a spectrum of diseases from otitis media with effusion (OME) to chronic suppurative otitis media. For all the OM diagnoses, Australian Indigenous children have higher rates of early onset, severe and persistent disease. OME is the most common form of OM and often occurs after an upper respiratory tract infection. It can be difficult to diagnose (and often goes unrecognised). Hearing loss is the most important complication. The middle-ear effusion impedes the movement of the tympanic membrane and causes a conductive hearing loss of around 25 dB. Around 20% will have a hearing loss exceeding 35 dB. Children with early onset, persistent, bilateral OME and hearing loss (or speech delay) are most likely to benefit from interventions. However, the impact of all the effective treatment options is modest. Giving advice about effective communication strategies for young children is always appropriate. The best evidence from randomised trials supports not using antihistamines and/or decongestants, considering a trial of antibiotics and referral for tympanostomy tubes. Despite the availability of evidence-based guidelines, giving advice about treatment is a challenge because recommendations vary according to condition, age, risk of complications and parental preference. While most children with OME can be effectively managed in primary care, we need to get children who meet the criteria for simple ear, nose and throat procedures that improve hearing on to ear, nose and throat surgery waiting lists. Long delays in hearing support may contribute to life-long social and economic disadvantage.

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Water precautions for prevention of infection in children with ventilation tubes (grommets)

Cited by 24 publications

References 23 publications

Consulting Dr. Google: Quality of Online Resources About Tympanostomy Tube Placement

Consulting Dr. Google: Quality of Online Resources About Tympanostomy Tube Placement

Preventative and medical treatment of ear disease in remote or resource-constrained environments

Ear, nose and throat surgery: All you need to know about the surgical approach to the management of middle‐ear effusions in Australian Indigenous and non‐Indigenous children

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