From the Guidelines
After a tonsillectomy, patients should avoid swimming for at least 2 weeks, but for grommet (tympanostomy tube) insertion, there is no need for routine swimming exclusion or water precautions, as stated in the 2022 clinical practice guideline: tympanostomy tubes in children update 1. The available clinical evidence continues to find no clinically significant reduction in otorrhea with routine water precautions, and water avoidance is at a minimum a social inconvenience and at worst a detriment to developing water safety skills for young children 1. Some key points to consider are:
- The risk of infection and disruption to the healing process is a concern, but water pressure from surface swimming or shallow diving is unlikely to allow middle ear penetration 1.
- Water contamination in the middle ear does not invariably cause infection, and if it should occur, the TTO is usually painless and readily managed with antibiotic ear drops 1.
- Water precautions may be prudent for some children in defined clinical situations, such as those with recurrent or persistent otorrhea, immune dysfunction, or exposure to heavily contaminated water 1. The 2022 guideline recommends against routine water precautions after tympanostomy tubes, and this recommendation should be incorporated into the preoperative counseling of families of children before surgery and into the knowledge base of all practitioners who care for children after such surgery 1. In terms of specific swimming exclusion periods, the evidence does not support a specific duration, but rather emphasizes the importance of individualized assessment and counseling based on the child's specific needs and risk factors 1. Overall, the focus should be on promoting water safety and hygiene practices, rather than imposing unnecessary restrictions on swimming and water activities for children with grommets 1.
From the Research
Tonsillectomy and Grommet Insertion Swimming Exclusion Period
- The recommended swimming exclusion period after tonsillectomy and grommet (tympanostomy tube) insertion is not directly addressed in the provided studies 2, 3, 4, 5, 6.
- However, the studies provide information on postoperative complications and recovery periods for tonsillectomy and grommet insertion.
- For tonsillectomy, the recovery period can last up to 11-12 days, with significant pain being the main problem 4.
- The risk of post-tonsillectomy hemorrhage is highest in the first 24 hours, but can occur up to 10 days after surgery 3.
- For grommet insertion, the most common complication is postoperative otorrhoea (discharge), with a reported incidence ranging from 10% to 50% 5.
- There is no clear consensus on the swimming exclusion period after these procedures, but it is generally recommended to avoid swimming for at least 1-2 weeks after tonsillectomy and grommet insertion to minimize the risk of complications.
- It is essential to follow the specific advice of the surgeon or healthcare provider, as the recommended swimming exclusion period may vary depending on individual circumstances 2, 3, 4, 5, 6.