Surfer's ear is the common name for an

exostosis An exostosis, also known as bone spur, is the formation of new bone on the surface of a bone. Exostoses can cause chronic pain ranging from mild to debilitatingly severe, depending on the shape, size, and location of the lesion. It is most commonl ...

or abnormal bone growth within the

ear canal The ear canal (external acoustic meatus, external auditory meatus, EAM) is a pathway running from the outer ear to the middle ear. The adult human ear canal extends from the pinna (anatomy), pinna to the eardrum and is about in length and in di ...

. Surfer's ear is not the same as swimmer's ear, although infection can result as a side effect. 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. Where the ear canal is actually blocked by this condition, water and wax can become trapped and give rise to infection. The condition is so named due to its prevalence among cold water

surfers Surfing is a surface water sport in which an individual, a surfer (or two in tandem surfing), uses a board to ride on the forward section, or face, of a moving wave of water, which usually carries the surfer towards the shore. Waves suitable ...

. Warm water surfers are also at risk for exostosis due to the evaporative cooling caused by wind and the presence of water in the ear canal. Most avid surfers have at least some mild bone growths (exostoses), causing little to no problems. The condition is progressive, making it important to take preventive measures early, preferably whenever surfing. The condition is not limited to surfing and can occur in any activity with cold, wet, windy conditions such as

windsurfing Windsurfing is a wind propelled water sport that is a combination of sailing and surfing. It is also referred to as "sailboarding" and "boardsailing", and emerged in the late 1960s from the aerospace and surf culture of California. Windsurfing ga ...

kayak A kayak is a small, narrow watercraft which is typically propelled by means of a double-bladed paddle. The word kayak originates from the Greenlandic word '' qajaq'' (). The traditional kayak has a covered deck and one or more cockpits, each s ...

ing,

sailing Sailing employs the wind—acting on sails, wingsails or kites—to propel a craft on the surface of the ''water'' (sailing ship, sailboat, raft, windsurfer, or kitesurfer), on ''ice'' (iceboat) or on ''land'' ( land yacht) over a chose ...

jet skiing A personal watercraft (PWC), also called water scooter or jet ski, is a recreational watercraft that a rider sits or stands on, not within, as in a boat. PWCs have two style categories, first and most popular being a runabout or "sit down" whe ...

kitesurfing Kiteboarding or kitesurfing is a sport that involves using wind power with a large power kite to pull a rider across a water, land, or snow surface. It combines aspects of paragliding, surfing, windsurfing, skateboarding, snowboarding, and wak ...

, and diving.

Signs and symptoms

In general, one ear will be somewhat worse than the other due to the prevailing wind direction of the area surfed or the side that most often strikes the wave first. * Decreased hearing or hearing loss, temporary or ongoing * Increased prevalence of ear infections, causing ear pain *Difficulty evacuating debris or water from the ear causing a plugging sensation Image:Normal canal Image001.jpg, Normal ear canal Image:Normal canal 2 Image001.jpg, Normal ear canal Image:Exostosis Image001.jpg, Exostosis in ear canal Image:Exostosis Image002.jpg, Exostosis in ear canal

Cause

The majority of patients present in their mid-30s to late 40s. This is likely due to a combination of the slow growth of the bone and the decreased participation in activities associated with surfer's ear past the 30s. However, surfer's ear is possible at any age and is directly proportional to the amount of time spent in cold, wet, windy weather without adequate protection. The normal ear canal is approximately 7 mm in diameter and has a volume of approximately 0.8 ml (approximately one-sixth of a teaspoon).Ojala K, Sorri M, Sipila P, Vainio-Mattila J. Correlation of postoperative ear canal volumes with obliteration material and with volume of operation cavity.Arch Otorhinolaryngol 1982; 234: 37-43. As the condition progresses, the diameter narrows and can even close completely if untreated, although people generally seek help once the passage has constricted to 0.5–2 mm due to the noticeable hearing impairment. While not necessarily harmful in and of itself, constriction of the ear canal from these growths can trap debris, leading to painful and difficult to treat

infections An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable di ...

Prevention

The widespread use of wetsuits has allowed people to surf in much colder waters, which has increased the incidence and severity of surfer's ear for people who do not properly protect their ears. *Avoid activity during extremely cold or windy conditions. *Keep the ear canal as warm and dry as possible. **

Ear plugs An earplug is a device that is inserted in the ear canal to protect the user's ears from loud noises, intrusion of water, foreign bodies, dust or excessive wind. Since they reduce the sound volume, earplugs are often used to help prevent hearing ...

** Wetsuit hood **

Swim cap A swimming cap, swim cap or bathing cap, is a tightly fitted, skin-tight garment, commonly made from silicone, latex or lycra, worn on the head by recreational and competitive swimmers. Swim caps are worn for various reasons: they can be worn to ...

Diving helmet A diving helmet is a rigid head enclosure with a breathing gas supply used in underwater diving. They are worn mainly by professional divers engaged in surface-supplied diving, though some models can be used with scuba equipment. The upper part ...

Treatment

Surgery to remove the obstructing ear canal bone is usually performed under

general anesthesia General anaesthesia (UK) or general anesthesia (US) is a medically induced loss of consciousness that renders the patient unarousable even with painful stimuli. This effect is achieved by administering either intravenous or inhalational general ...

in an operating room and aided by the use of a binocular microscope. Most ear surgeons use a drill to remove the bone and may approach the area directly via the ear canal or by making an incision behind the ear and dissecting the ear forward. In using a drilling technique, it is important to keep the thin inner ear canal skin away from the drill to preserve the skin and allow optimal skin coverage at the conclusion of the surgery. Some doctors now prefer to use 1 millimeter chisels to remove the obstructing bone and enter directly through the ear canal. This technique enhances skin preservation. This technique may, in some cases, be performed under

sedation Sedation is the reduction of irritability or agitation by administration of sedative drugs, generally to facilitate a medical procedure or diagnostic procedure. Examples of drugs which can be used for sedation include isoflurane, diethyl ether, ...

with

local anesthesia Local anesthesia is any technique to induce the absence of sensation in a specific part of the body, generally for the aim of inducing local analgesia, that is, local insensitivity to pain, although other local senses may be affected as well. It ...

. During recuperation from surgery, it is extremely important not to expose the ear canal to water to minimize the chance of infection or complications. Depending on the condition of the ear canal and the surgical technique used, the ear canal may require several weeks to several months to heal. 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.

References

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External links