How does water cause infection in tympanic membrane perforation (TMP)?

Updated: Dec 14, 2020
  • Author: Robert A Saadi, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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If bacteria-contaminated water enters the ear canal, the presence of a perforation renders the ear more susceptible to infection. Water precautions are therefore recommended, particularly for large perforations, including the use of earplugs while swimming and avoidance of submerging the head in water when possible. Water surface tension may protect the ear from penetration through a very small perforation. The presence or history of perforation is an absolute contraindication to irrigation for cerumen removal. For patients who have undergone a myringotomy and ventilation tube insertion, consensus guidelines recommend that water precautions not be routinely used, given the limited proven benefit. [16]

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