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What Causes Surfer’s Ear?
Repeated exposure of your ear canal to cold water and wind can cause surfer’s ear.
It’s the evaporative cooling of the ear canal that stimulates bone growth. Excessive bone growth can start to block your ear canal, changing the way sound travels to the eardrum and increases the risk of infection due to water and debris getting trapped behind the bony lumps.
Some surfers have large exostoses on one side and small or none on the other. Presumably, this is because of the prevailing wind direction at their local beaches.
Some people are also more inclined to develop surfer’s ear, and it’s thought this could be due to genetic reasons.
Surfing is not the only activity that is associated with exostosis of the ear canal. Swimming, diving, jet-skiing, and even driving a convertible can cause abnormal bone growths in the ear from repeated exposure to wind, water and evaporative cooling.
What Is External Auditory Exostosis?
Exostosis is a non-cancerous (or benign) growth of new bone over existing bone.
Surfer’s ear is medically known as external auditory exostosis: A broad-based bone lesion grows from the temporal bone and projects into the external auditory canal. The image below is a magnified view of surfer’s ear inside the ear canal.
Your temporal bones are at the sides and base of your skull.
Exostosis is also called osteoma and a bone spur.
Many types of exostosis may occur on a wide range of bones in the human body, including:
- Footballer’s ankle (a lesion on the ankle bone)
- Buccal exostosis (a lesion on the lower jaw or upper jaw)
- Hereditary multiple exostoses (multiple bone lesions)
- Subungual exostosis (a lesion on the tip of the toe or finger)
- Torus mandibularis (a lesion on the lower jaw)
- Torus palatinus (a lesion on the roof of the mouth)
Surfer’s Ear Symptoms
You may have surfer’s ear and be completely symptom-free.
Patients will typically present with a secondary complaint such as ear pain, hearing loss, or a sensation of fullness in the ear (called occlusion).
Early symptoms of surfer’s ear include water or debris becoming trapped in the ear more frequently, and it also becomes harder to get the water and debris out. If the water and debris remain trapped for long enough, this increases the risk of ear infections.
If your ear canal narrows further with the continued growth of the exostoses, ear infections can take longer to settle and become more frequent.
More significant narrowing of the ear canal due to growth of the exostoses will eventually result in conductive hearing loss.
Diagnosing and Treating Surfer’s Ear
Surfer’s ear is identified using an otoscope or microscope to view the bony growths protruding under the skin of the ear canal.
Patient history is essential in making a diagnosis of this disease. You likely have many years of repetitive exposure to cold water and wind, often through water activities such as surfing, swimming or kayaking.
Using a microscope like the one commonly used in Microsuction, surfer’s ear is easily identified by your ear nurse.
If the condition is causing pain, conductive hearing loss, or repeated ear infections, you’ll need a referral to an otolaryngologist (ear, nose and throat specialist) for treatment.
The only way to treat exostosis of the external auditory canal definitively is to remove the bony growths surgically. The procedure is often performed through the ear canal using tiny chisels.
Operating on surfer’s ear is among the most challenging surgeries that an Ear Nose and Throat Surgeon can perform.
For the patient, it can be challenging, too, as the mere thought of someone chiselling bone in your ear canal is pretty terrifying.
Is Surfer's Ear Painful?
Surfer’s ear is usually not painful. However, earache caused by repeated ear infections can be very painful.
Pain is more often a secondary result of an ear infection incited by external auditory exostoses.
Is Surfers Ear the Same as Swimmers Ear?
Surfer’s ear is not the same as swimmer’s ear. An infection does not cause exostoses or bony growth inside your ear canal, but swimmer’s ear is.
However, they are commonly associated as surfer’s ear carries the risk of ear infection of the outer ear canal or otitis externa.
If you have surfers ear, the water trapped inside your ear canal can cause an infection. This infection is commonly referred to as swimmer’s ear. You may initially present with symptoms of swimmer’s ear if water is trapped inside your ear because of surfer’s ear.
How to Prevent Surfer’s Ear
As they say, prevention is better than cure, especially when the treatment can mean someone drilling out your ear canal.
The best prevention is to protect your ears from cold water and wind when you can. Earplugs, a wetsuit hoody, earmuffs, or a hat that helps shield your ears will likely help.
Custom-fit swimmers or surfers earplugs can work well for those who frequent cold, wet and windy environments.