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Surfer's Ear


Overview

Surfer’s Ear is the common name for exostosis, abnormal bone growth, within the ear canal. Surfer’s ear is not the same as swimmer’s ear.

Irritation from cold wind and water exposure causes the bone surrounding the ear canal to develop lumps of new bony growth which constrict the ear canal. The condition is so named due to its prevalence among cold water surfers. Cold water surfers experience surfer’s ear at about six times the rate of warm water surfers.

The condition is not limited to surfing and can occur in any activity with cold, wet, windy conditions such as kayaking, sailing,diving. Most avid surfers have at least some mild bone growths (exostoses), causing little to no problems.[1] The condition is progressive, making it important to take preventative measures early, preferably whenever surfing.

Etiology

Symptoms

In general one ear will be much worse than the other due to the areas prevailing wind direction or the side that most often strikes the wave first.

Treatment

Traditionally surfer’s ear has been treated by exostectomy wherein a small incision is opened behind the ear and the bone growth is removed using a surgical drill. When exostoses are completely removed there is little chance of recurrence requiring repeat surgery in the future. The postauricular approach minimizes complications by providing a proper operative trajectory to the exostoses.[2]

During recuperation it is extremely important not to return to the water for at least four weeks to avoid infection or complications. The operation is performed under general anesthesia.

Some doctors now use extremely small chisels and enter directly through the ear canal. While not requiring an incision behind the ear, this procedure has resulted in accidental mobilization of the ear canal in several cases, and still requires use of a drill near the eardrum.[3]

Unprotected exposure of ear canals to cold water and wind after treatment can lead to regrowth of bone and the need for repeated operations on the same ear.

Prevention

Just as it iss possible that motorcycle helmets increase nonhead related injuries due to increased risk-taking , the widespread use of wetsuit hoods, caps, and neoprene bands has allowed people to surf in much colder waters, which probably has increased the incidence and severity of surfer’s ear for those that don’t properly protect their ears.

Other recommendations:

  • Avoid activity during extremely cold or windy conditions.
  • Keep the ear canal as warm and dry as possible.
    • Ear plugs
    • Neoprene hood
    • swim cap

References

  1. Wong, B (1999). “Prevalence of external auditory canal exostoses in surfers”. Archives of Otolaryngology, Head and Neck Surgery. 125: 969–972. Unknown parameter |coauthors= ignored (help)
  2. House, J (2008). “External auditory exostoses: evaluation and treatment”. Otolaryngology Head and Neck Surgery. 138: 672–678. Unknown parameter |coauthors= ignored (help)
  3. Hetzler, MD, Douglas. “Relief for Surfer’s Ear”. Santa Cruz Medical Clinic.

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