Surfer’s ear, also known as exostosis, is an abnormal growth of bone inside the ear canal. In its advanced stages, the exostoses can severely narrow the ear canal and cause trapping of water and wax, which can lead to infections and hearing loss.
Surfer’s ears take years to form, usually after being exposed to cold water or air. It is common in swimmers and surfers who dip their ears in cold water, but it can also occur in patients who have a long history of ear exposure in other cold, windy, and wet conditions such as sailing, skiing, and windsurfing. Sometimes the exostosis can even happen randomly without a known reason.
The ear canal is made of 1/3 cartilage and 2/3 bone. The area affected by Surfer’s ear is the bony canal. Over the course of years, the bone is slowly remodeled and forms lumps of new bony growth which narrow the ear canal.
As of now the only method of getting rid of exostoses is by surgery, which physically removes these lumps and restores the original shape of the ear canal. If your exostoses are in the early stage, you could prevent them from getting larger by avoiding further exposure to cold water and wind.
There are various methods to remove the exostoses. Most of the techniques involve exposing the ear canal directly under an operating microscope. A small incision is made over the lump of bone and the skin is rotated away to expose the underlying bone. Then, either a drill or a small chisel is used to carefully remove the bony lumps in the canal. Once the bone is removed, the skin is rotated back over the canal and packing is placed to hold the skin together inside the ear canal. There are no incisions made anywhere except inside the ear canal. There surgery does not require sutures.
The surgery takes place in an outpatient setting and usually takes about an hour to perform. After the surgery, the patient is discharged home with pain medications and antibiotics. There is minimal pain associated with the surgery, and usually the patients take little or no pain medications for about 1-2 days after the surgery. The patient can usually start performing light activities around the house and in the office the day after the surgery. The ear packing is removed about 1-2 weeks after the surgery, and depending on the exam, the patient can return to swimming or surfing about 2-4 weeks after the surgery.
The chances of complications with exostosis surgery are very rare. Like any surgery, the most common risk is infection. Extra care is taken to perform the surgery in a sterile environment, and antibiotics are given both before and after the procedure to help prevent any infection. Sometimes the exostosis can be very close to the eardrum, and extra care must be taken to avoid any injury to the eardrum which can lead to hearing loss.
Having exostoses is not a life-threatening problem, but it can lead to many issues with quality of life. Since wax can get easily trapped behind the bony lumps, it can lead to hearing loss and may require frequent cleanings by your doctor. The exostoses can also make you more prone to ear infections, which could be harder to treat successfully as the exostoses become larger. With time, the exostoses can become large enough to cause hearing loss since sound can not reach the ear drum due to blockage of the ear canal.
Our institute recommends at least 1-2 weeks before getting back in the water after surgery, but it all depends on how good the healing appears on your post-operative visit.
It’s good to keep in mind that the exostoses could recur if the ears are re-exposed to cold temperatures, but this usually happens over many years of frequent exposure. It’s very rare for the exostoses to recur otherwise.