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Submersion with grommets: contamination is possible at minimal depth, as demonstrated with a novel middle-ear model

Published online by Cambridge University Press:  07 January 2022

E Farrell Open the ORCID record for E Farrell [Opens in a new window] ,
A Gendre Open the ORCID record for A Gendre [Opens in a new window] ,
L Viani ,
F Glynn  and
P Walshe
E Farrell*
Affiliation:
Viani Hearing Institute, Department of Otology and Cochlear Implantation, Beaumont University Hospital, Dublin, Ireland
A Gendre
Affiliation:
Viani Hearing Institute, Department of Otology and Cochlear Implantation, Beaumont University Hospital, Dublin, Ireland
L Viani
Affiliation:
Viani Hearing Institute, Department of Otology and Cochlear Implantation, Beaumont University Hospital, Dublin, Ireland
F Glynn
Affiliation:
Viani Hearing Institute, Department of Otology and Cochlear Implantation, Beaumont University Hospital, Dublin, Ireland
P Walshe
Affiliation:
Viani Hearing Institute, Department of Otology and Cochlear Implantation, Beaumont University Hospital, Dublin, Ireland
*
Author for correspondence: Dr Eric Farrell, Viani Hearing Institute, Department of Otology and Cochlear Implantation, Beaumont University Hospital, Dublin 9, Ireland E-mail: farrelea@tcd.ie
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Abstract

Objective

Advice to patients following grommet insertion and waterproofing can vary from clinician to clinician. A laboratory based experiment was performed to determine at what depth water contamination would occur through various grommet tubes.

Methods

A novel experimental ear model was developed using an artificial tympanic membrane and ventilation tubes. Water contamination was identified using an effervescent solid that reacts when in contact with water. Measures of dispersion were used to describe the results.

Results

The average depth of water contamination was: 19.64 mm (range = 11–33 mm, standard deviation = 5.55 mm) using a Shepard grommet; 20.84 mm (range = 18–26 mm, standard deviation = 1.97 mm) with a titanium grommet; and 21.36 mm (range = 18–33 mm, standard deviation = 3.03 mm) using a T-tube. Water contamination was possible at depths of 11–33 mm. The average pressure at water effervescent activation was 0.20 kPa.

Conclusion

Submersion underwater at any depth with grommets is likely to lead to middle-ear contamination. These findings are concordant with clinical studies.

Keywords

Ear, MiddleMiddle Ear VentilationOtitis MediaOtitis Media With EffusionDivingTympanic Membrane
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 7 , July 2022 , pp. 632 - 634
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr E Farrell takes responsibility for the integrity of the content of the paper

References

Basu, S, Georgalas, C, Sen, P, Bhattacharyya, AK. Water precautions and ear surgery: evidence and practice in the UK. J Laryngol Otol 2007;121:9–14CrossRefGoogle ScholarPubMed
Moualed, D, Masterson, L, Kumar, S, Donnelly, N. Water precautions for prevention of infection in children with ventilation tubes (grommets). Cochrane Database Syst Rev 2016;27:CD010375Google Scholar
Miyake, MM, Tateno, DA, Cançado, NA, Miyake, MM, Tincani, S, Sousa, OMD. Water protection in patients with tympanostomy tubes in tympanic membrane: a randomized clinical trial. Einstein (São Paulo) 2019;17:eAO4423CrossRefGoogle ScholarPubMed
Subtil, J, Jardim, A, Araujo, J, Moreira, C, Eça, T, McMillan, M et al. Effect of water precautions on otorrhea incidence after pediatric tympanostomy tube: randomized controlled trial evidence. Otolaryngol Head Neck Surg 2019;161:514–21CrossRefGoogle ScholarPubMed
Ricks, RG, Easto, R, Reddy, VM. The water penetration of different ventilation tubes. Eur Arch Otorhinolaryngol 2016;273:3131–4CrossRefGoogle ScholarPubMed
Ibrahim, Y, Fram, P, Hughes, G, Phillips, P, Owens, D. Water penetration of grommets: an in vitro study. Eur Arch Otorhinolaryngol 2017;274:3613–17CrossRefGoogle Scholar
Hebert, RL 2nd, Vick, ML, King, GE, Bent, JP 3rd. Tympanostomy tubes and otic suspensions: do they reach the middle ear space? Otolaryngol Head Neck Surg 2000;122:330–3CrossRefGoogle ScholarPubMed