Cohen H A, Kauschansky A, Ashkenasi A, Bahir A, Frydman M, Horev Z
Ambulatory Pediatric Center, Petach Tiqwa, Israel.
J Fam Pract. 1994 Jan;38(1):30-2.
Traditionally, children with tympanostomy ventilating tubes, or grommets, were advised that water should not enter their ears in order to prevent ear infections. This group of children has been considered somewhat handicapped regarding swimming. We conducted a prospective study to determine if there is a relation between suppurative otitis media and surface swimming in children with grommets.
Forty-two children with tympanostomy ventilating tubes were included in this study. Of the 42 children, 22 were swimmers and 20 were nonswimmers, who served as the control group. The age range was 3 to 12 years, and there was no difference in the age distribution between the groups. Surface swimming was allowed without earplugs or a bathing cap, although it was mandatory to use polymyxin B-neomycin-hydrocortisone eardrops at bedtime on the day of swimming. No diving was allowed.
Three of 22 swimmers and 2 of 20 nonswimmers developed otorrhea. In 4 of the 5 children, the otorrhea was followed by an upper respiratory tract infection. In all cases, a bacterial culture revealed Pseudomonas. The ear drainage was easily controlled with local otic treatment in all the patients.
Taking into consideration the possible risks of infection and bearing in mind the value and joy of swimming to children and parents, families should be reassured that surface swimming does not increase the risk of infection in children with tympanostomy tubes.
传统上，建议鼓膜置管（即耳内通气管）儿童不要让水进入耳朵，以防耳部感染。这类儿童在游泳方面被认为有些不便。我们进行了一项前瞻性研究，以确定鼓膜置管儿童的化脓性中耳炎与公开水域游泳之间是否存在关联。
本研究纳入了42名鼓膜置管儿童。在这42名儿童中，22名是游泳者，20名是非游泳者，后者作为对照组。年龄范围为3至12岁，两组之间的年龄分布没有差异。允许在不使用耳塞或泳帽的情况下进行公开水域游泳，不过在游泳当天晚上睡觉时必须使用多粘菌素B - 新霉素 - 氢化可的松耳滴液。禁止跳水。
22名游泳者中有3名、20名非游泳者中有2名出现耳漏。在这5名儿童中的4名中，耳漏之后出现了上呼吸道感染。在所有病例中，细菌培养显示为铜绿假单胞菌。所有患者通过局部耳部治疗，耳部分泌物都很容易得到控制。
考虑到可能存在的感染风险，并铭记游泳对儿童及其父母的价值和乐趣，应让家庭放心，公开水域游泳不会增加鼓膜置管儿童的感染风险。
