Tympanostomy tubes (ear tubes) are small, cylindrical devices surgically placed through the eardrum to manage recurrent middle ear infections or persistent fluid buildup. Their primary function is to ventilate the middle ear space, allowing accumulated fluid to drain and equalizing pressure. The tube creates a direct, small opening through the eardrum, which changes how the ear interacts with the outside environment and water exposure. This guidance provides practical steps for safely navigating water exposure when ear tubes are present.
Why Water Exposure Requires Caution
The eardrum naturally acts as a barrier, protecting the middle ear from the external environment. Ear tubes temporarily bypass this natural defense mechanism, connecting the outer ear canal directly to the middle ear space. This channel means water entering the ear canal has a potential pathway to the middle ear.
The main concern is that water carries microorganisms, especially in non-sterile settings. Bacteria or irritants from water can travel through the tube and introduce infection to the middle ear (otitis media). This risk is particularly elevated with water that has a low surface tension, such as soapy bathwater or environmentally contaminated water.
While some guidelines suggest water precautions are not always necessary, deep submersion or exposure to non-chlorinated sources remains a higher risk. Sources like lakes, rivers, or oceans contain a greater concentration of microbes than a properly maintained, chlorinated swimming pool. Soapy water from a shower or bath also poses a threat because soap lowers the water’s surface tension, increasing its likelihood of passing through the tube opening.
Essential Protection Strategies for Tubes
Proactive protection is the most effective way to prevent water from reaching the middle ear space. Methods should be tailored to the type of water exposure encountered. For routine activities like showering or bathing where the head is not submerged, simple methods often provide sufficient protection.
One simple, effective method involves using cotton balls coated with petroleum jelly to create a waterproof seal over the ear canal opening. The petroleum jelly repels moisture, preventing water from soaking through the cotton barrier and into the ear. This method is suitable for surface activities where splashing is minimal.
For more active water exposure, such as swimming or intentional head submersion, specialized ear protection is highly recommended. Pre-molded silicone putty plugs are designed to tightly seal the ear canal entrance and are available at most pharmacies. Custom-molded earplugs, made by an audiologist, offer the most reliable and personalized seal for rigorous water activities.
These plugs can be reinforced with an additional layer of protection, such as a neoprene headband or a swim cap pulled down over the ears. This combination provides a secondary barrier and helps secure the earplugs in place during vigorous swimming or diving. Even with protection, deep diving below six feet is discouraged due to the pressure differential that could force water past the seal.
Immediate Response When Water Enters the Ear
If water is suspected to have entered the ear, the immediate goal is to safely and passively encourage the moisture to drain out. Aggressive drying methods must be avoided, as they can cause trauma or push water and debris further into the ear canal or middle ear. Never attempt to use cotton swabs, fingers, or any other object to remove moisture, as this risks injury or impaction.
A gravity-assisted approach is the first step: tilt the head so the affected ear points toward the ground. Gently pulling the earlobe in different directions helps straighten the ear canal, allowing water to flow out more easily. Remain in this position for a few minutes to allow the water to drain naturally.
A low-heat hairdryer can be used to evaporate residual moisture from the outer ear canal. Set the dryer to the lowest or coolest setting and hold it at least 12 inches away from the ear to avoid burns or discomfort. Direct the air stream toward the ear canal for a few moments, ensuring the air moves the water out, not inward.
If a physician has prescribed antibiotic ear drops for use after water exposure, administer them immediately following passive drying techniques. To ensure the drops reach the middle ear through the tube, gently press the small flap of cartilage in front of the ear canal (the tragus) several times after application. This “pumping” action helps push the medication through the tube.
Recognizing Signs of Ear Infection
Even with preventative measures, a middle ear infection can still occur following water exposure or due to other reasons, such as an upper respiratory infection. The presence of an infection while tubes are in place often presents differently than a typical ear infection. The tube allows the infection to drain, which usually relieves the intense pressure and pain commonly associated with infections.
The most noticeable sign of a problem is drainage (otorrhea) from the ear canal. This discharge may be clear, cloudy, yellow, green, or slightly bloody, and can sometimes have a foul odor. The drainage indicates that the middle ear is infected and actively draining through the tube.
Other symptoms signaling a potential infection include persistent ear discomfort or pain lasting longer than a few hours after water exposure. A low-grade fever (generally between 99.5 and 100.3 degrees Fahrenheit) may also be present. Any sudden change in hearing, such as muffled sounds, or a child tugging at the ear, warrants attention.
If any of these signs appear, particularly visible discharge, professional medical attention is necessary. Home remedies are insufficient for treating a bacterial infection in the middle ear; a healthcare provider will prescribe specialized antibiotic ear drops. If drainage persists for more than seven days while using the prescribed drops, or if the fever increases, contact the physician for follow-up evaluation.