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If you live near the coast, warm weather often means heading to the beach for a day of fun in the sun. Sandcastles, sunbathing, and for the intrepid, thrill-seeking adventurer: surfing! For the chronic beach-heads, however, surfer’s ear is a condition that merits as much attention as catching the next big wave.

Surfer’s ear is the common name for an exostosis (abnormal bone growth) within the ear canal, often occurring bilaterally (affecting both ears). Irritation from cold wind and water exposure causes the bone surrounding the ear canal to develop masses of new bony growth, which can constrict the ear canal. When the ear canal is actually blocked, water and wax can become trapped and give rise to infections within the ear canal. Despite the prevalence in cold-water surfers, warm-water surfers are also at risk for exostosis due to evaporative cooling caused by wind and the presence of water in the ear canal.

 Getting water in your ear is irritating, but can also be harmful.

Image Source: Alissa Hankinson

Most avid surfers have at least some mild exostoses (bone growths), causing little to no problems. The majority of patients present symptoms in their mid-30s to late 40s, due to the slow growth of the bone. The condition is not limited to surfing and can occur in any activity with cold, wet, and windy conditions such as windsurfing, kayaking, sailing, jet skiing, kitesurfing, and diving. A combination of factors in medical and social history are often used to diagnose surfer’s ear; decreased hearing and a history of extensive water exposure often corroborates with the physical findings of bony growths in the ear canal.

Treatment of surfer’s ear is often at the discretion of the patient, but it is generally recommended for those with marked hearing loss to be treated. Surgery to remove the obstructing ear canal bone is usually performed under general anesthesia in an operating room by incising behind the ear and dissecting the ear forward. New methods include chiseling the obstructing bone and entering directly through the ear canal, which enhances skin preservation.

Ultimately, the most important thing to keep in mind is prevention of exostoses. Taking proper ear precautions while in cold water vastly reduces the likelihood for the development of surfer’s ear. This may include the use of ear plugs, neoprene hoods, or special wetsuits that cover the ear.

Feature Image Source: Justin Chin

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