Water precautions and ear surgery: Evidence and practice in the UK

Background: Patients are traditionally advised to refrain from exposing their ears to water after most otological procedures. However, recent evidence suggests that water does not adversely affect the outcome for children with tympanostomy tubes. The evidence behind the potential harmful effects of water on the outcome of other otological procedures is scarce. Objective: The study was done to determine the current practice of otolaryngology consultants in the UK on the advice given to patients regarding swimming, diving and bathing in soapy water after myringotomy and tympanostomy tube insertion, mastoidectomy and myringoplasty. Method: Questionnaire based survey mailed to 382 members (consultants only) of the British Association of Otolaryngologists - Head & Neck Surgeons in the UK. Results: A total of 195 responses were received (reply rate 51 per cent). In all, 95.6 per cent of the respondents allowed their patients to swim after insertion of tympanostomy tubes, with 32.9 per cent insisting on the use of earplugs until extrusion of the tympanostomy tubes. However, 61.6 per cent of the respondents restricted diving in these patients. In comparison, the respondents were more conservative with water precautions following myringoplasty and mastoidectomy. More than half the respondents recommended earplugs for bathing after all three operations. Conclusion: This study reveals current national practice among UK otolaryngologists. There is no general consensus in post-operative advice following otolaryngological procedures, indicating a need for national guidelines.