What’s An Exostosis Ear?

Exostoses is a medical term for a benign overgrowth of bone in the ear canal. The extra bone formation occurs in the inner ⅓ of the ear canal, and typically occurs after several exposures to very cold water. These bone growths are typically seen in people that spend a lot of time in cold water, such as surfers, swimmers and divers. However, sometimes these growths can also be found in people that have no prior history of cold-water exposure. Typical presentation of exostoses includes multiple round bony overgrowths. Exostoses are typically found bilaterally as well, because when you are exposed to cold water, it will affect both ears. Another type of overgrowth of bone is called osteomas, but those usually occur in a single growth. Most of the time, exostoses do not require any intervention or treatment. However, there are occasions where the growths can be big enough, or there are so many of them, that it can impede hearing and cause a conductive hearing loss. Occasionally, the growths can also trap water, which can lead to otitis externa, or swimmer’s ear.

What is a surfer’s ear?

Surfer’s ear is the common name for exostoses. It is called surfer’s ear because exostoses are typically found in surfers, divers or swimmers that are exposed to cold water. Exostoses are typically found in both ears as well. And to differentiate between another type of bony growth, there are usually multiple growths found in the same ear canal.

What are the symptoms of a surfer’s ear?

Symptoms of a surfer’s ear can have a wide range. At times, if exostoses are small enough, you might not even be able to tell you have a surfer’s ear unless you looked in the ear canal with an otoscope. Other symptoms could include having water trapped in the ears more frequently after swimming. Water can be removed from the ear by using over the counter drops that contain a drying agent. So, because water gets trapped more easily due to these extra bony growths, it is possible to develop otitis externa, or swimmer’s ear. Swimmer’s ear is an infection of the ear canal. So, if you are diagnosed with a surfer’s ear, it is important to keep the water out of your ears. Other symptoms can be worse, if the exostoses are very large. If the exostoses get large enough, they can block the sound from getting to the eardrum. Symptoms of this would be decreased hearing on the affected side. The hearing loss might improve, or get worse depending on if water is also in the ear canal, and trapped by the exostoses.

Can a surfer’s ear cause tinnitus?

In the worst cases of exostoses, or surfer’s ear, it is possible to develop tinnitus. However, you would probably also be experiencing symptoms of hearing loss as well. Hearing loss is known to make tinnitus seem worse. Tinnitus can sometimes be alleviated by treating the hearing loss. In this case, you would be treating the exostoses to help reduce the perception of the tinnitus. 

How is a surfer’s ear different from a swimmer’s ear?

Swimmer’s ear and a surfer’s ear are two different things. The medical term for swimmer’s ear is otitis externa. This is an infection of the ear canal. Symptoms of swimmer’s ear include redness, pain, swelling and sometimes discharge, and maybe even an odor. This type of infection is typically treated with antibiotic drops. Or in very severe cases, oral antibiotics as well. For prevention of swimmer’s ear, dry ear precautions such as using earplugs when swimming will be recommended if exposure to water occurs often, or you have recurrent swimmer’s ear. There are over the counter options for ear plugs, as well as custom made swim plugs you can get from an audiologist. Surfer’s ear, also called exostoses, is an overgrowth of bone in the ear canal. There are typically few symptoms in the early stages of exostoses development. However, larger exostoses can cause swimmer’s ear, as the bony growths can trap water in the ear canal which leads to infection.

How do you prevent surfer’s ear?

Prevention methods of surfer’s ear would include avoiding swimming in cold water. But sometimes, that’s not feasible. We all have our hobbies! The other options could include wearing swim plugs to keep the cold water out of the ear canals, which would inhibit bone growth. There are also wetsuits that have hoods that would also be beneficial. Special headbands that cover and seals the ears are available as well. For added protection, one could always wear both earplugs and a sealing headband. For the times that the exostoses spontaneously grow without cold water exposure, there is no known prevention.

What are the treatment options for a surfer’s ear?

Treatments for surfer’s ear include waiting and watching them. Generally, they do not require any treatment. If the exostoses grow very large and block the hearing sensitivity, surgery is the only treatment option available at this time. There are a couple of surgical techniques, such as creating a small incision behind the ear and using a drill to remove the growths. In the second option, micro chisels are used to remove the bony growths. The best surgical technique is best left up to the physician. Most patients have favorable outcomes during the surgery, and typically experience little down time. It is important to avoid cold water exposure after surgery, or it is possible that the exostoses could grow back. 

What are the risks if I don’t treat my surfer’s ear?

Risks of not treating the surfer’s ear include increased ear infections and possible loss of hearing. 

How common is a surfer’s ear?

Cold water surfers and swimmers are 600 times more likely to develop exostoses than those that surf or swim in warm water. For the general population, there will be 6.3 cases out of 1000 people. For people who swim in cold water, one study found that there was a 73.5% overall prevalence of exostoses, or surfer’s ear in the surfing population.

In conclusion, exostoses are generally defined as bony overgrowth in the ear canal. They are typically present in clusters of more than one. They are more prevalent in the surfer and swimming community, as they are regularly exposed to cold water, which tends to increase bone growth in the ear canal. Exostoses are also called surfer’s ear because of the high number of surfers and swimmers that develop these growths. There are ways to prevent exostoses, such as wearing custom swim plugs, ear sealing headbands or hoods on wetsuits. Exostoses are generally asymptomatic. But, if they are left to grow larger, a surfer’s ear can cause increased ear infections and even possibly an eventual conductive hearing loss. Treatment is typically day surgery, and there are several techniques for removal of the growths, generally depending on how close to the eardrum the growths are located. To inhibit further growth, or recurrence, it is important to keep the ears clear of cold water by wearing ear plugs, a hood or special headband to keep the water out. 

Dr. Rebekah Tripp

Rebekah completed her Doctorate in Audiology from the University of Tennessee Health Science Center. She is a licensed audiologist in the State of Tennessee and a member of the Academy of Doctors of Audiology. She thrives on providing people with the best hearing healthcare available. You can find Rebekah at Choice Audiology, TN.
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Dr. Rebekah Tripp

Rebekah completed her Doctorate in Audiology from the University of Tennessee Health Science Center. She is a licensed audiologist in the State of Tennessee and a member of the Academy of Doctors of Audiology. She thrives on providing people with the best hearing healthcare available. You can find Rebekah at Choice Audiology, TN.
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