Ear tube surgery (myringotomy with tube placement) is a common procedure used to treat chronic middle ear fluid buildup or recurring infections. The tubes create an opening in the eardrum, allowing the middle ear to ventilate and fluid to drain. While this procedure is highly effective, it creates a direct pathway for outside water to enter the middle ear. A careful approach to post-operative water exposure is necessary to ensure the success of the treatment.
The Standard Timeline for Resuming Swimming
The time required before a patient can safely resume swimming varies, but initial healing is necessary. Most surgeons recommend waiting 24 to 48 hours before any water exposure involving head submersion, allowing the surgical site to stabilize. For full submersion, such as swimming laps, patients often wait until the post-operative follow-up appointment, typically one to two weeks after the procedure. During this visit, the surgeon confirms the ear canal is clear and the tubes are properly in place, providing official clearance for water activities.
Necessary Precautions and Water Type Considerations
Once cleared for swimming, protective measures are recommended, especially for certain types of water exposure. Custom-molded earplugs offer the highest level of protection by forming a watertight seal within the ear canal. Less expensive silicone or putty earplugs can also be used, often secured with a neoprene headband for added protection against dislodgement.
Water Source Risks
The risk of infection changes significantly depending on the water source. Heavily treated water, such as a clean, chlorinated swimming pool, is considered lower risk because the chemicals neutralize many bacteria. Non-treated bodies of water, including lakes, rivers, and the ocean, contain higher concentrations of pathogens, demanding strict use of ear protection. Protection is also advised when bathing or using hot tubs, as soapy or chemically treated water can pose a risk if it enters the middle ear.
Diving or swimming deeper than six feet underwater is discouraged while tubes are in place, even with earplugs. The increased pressure at depth can force water past the protective barrier or through the tube itself. For general surface swimming or splashing, protection may be optional in a clean, chlorinated pool, but any activity involving head submersion warrants the use of effective ear protection.
Understanding Why Water Exposure is Risky
The primary concern with water exposure is the potential for water to pass through the tube’s opening into the middle ear space. The middle ear is normally a sterile, air-filled cavity, and outside water can carry bacteria. If contaminated water enters this space, it can lead to an infection called acute otitis media. This infection often results in drainage, known as otorrhea (a discharge of fluid or pus from the ear canal). Although some studies suggest casual swimming in clean water may not increase infection incidence, the traditional precautionary advice remains to prevent water from reaching the middle ear.