Surfer’s Ear (Exostoses)
The photo on the left shows a normal ear canal, while the photo on the right is an ear canal with surfer’s ear, also called exostoses. Repeated cold water exposure causes irritation of the lining of the bone in the ear canal. The body responds to this by laying down a new layer of bone, and when this happens repeatedly over time a lump of bone is formed. In fact, if you cut these lumps up and look at them under a microscope, they look like a sliced onion because of the multiple layers of bone! Surfer’s ear is an entirely benign (non cancerous) lump.
Surfer’s ear is not only a problem for surfers. Anyone who swims in cold water frequently is more likely to get these (eg open water swimmers, kayakers).
Symptoms
Once they start blocking the ear canal, can cause wax and/or water trapping, causing temporary hearing loss or recurrent ear infections. Or there may be no symptoms at all if the exostoses are not blocking the ear canal.
Prevention
Wear ear plugs and/or a hood, particularly in cold water. Lots of my patients recommend Surf Ears (I’m not on commission!).
Surgical removal of exostoses FAQ’s
How many of these operations do you perform?
Because of my location in the South West, many of my patients are surfers and so I see more surfer’s ear than you might expect in other parts of the country. I currently perform around one a month.
How long should I leave it to have my surfer’s ear operation?
Generally it’s best to have the operation as soon as your ear starts causing you problems. It isn’t going to get any better by itself, and you have a really good chance of an excellent result if you have it done earlier, since it is more likely I will be able to use the chisel only and do the operation entirely down the ear hole.
What is involved in the surgery?
You will need a hearing test before and after surgery, and if you don’t live locally in Plymouth, you may be asked to arrange these yourself.
The operation is done as a day case and depending on the size of your ear canal and the extent of the disease, I may be able to perform it completely down the ear canal. Sometimes a cut is required just in front of or behind the ear.
The sleeve of skin in the ear canal covering the bony lumps is peeled back and the surfer’s ear is removed. As much as possible, this is done with a tiny chisel because it cuts down the risks of surgery compared to when the lumps of bone are removed with a drill. However, it is common to need to use the drill to get a smoothe finish to the ear canal, but I try to limit its use.
Will you use a chisel or a drill?
It depends on the extent of the exostoses. Generally, if there is a gap of around 3mm, I can use the chisel. If your exostoses are worse than that, I am more likely to need to use the drill, although I always try to minimise its use.
What is the post-op care?
After the operation, some antibiotic/steroid dressings are placed in the ear canal, which may need to be changed once or twice during the post op period. I will need to remove the packs myself, rather than another ENT surgeon removing them if you live far away. So you will need at least 2 post op visits to see me: one at 2 weeks and one at around 3 months (occasioanlly more if healing is slow).
When can I go back in the water?
Usually, the ear is fully healed by 2-3 months after surgery, but during that time, I strongly recommend keeping the ear dry and avoiding surfing.
I have surfer’s ear on both sides. Can I get them both done at once?
No, it is not possible to do them both at once, but if necessary, we can try to schedule surgery on the second side to suit you. If you would like to have the two sides done consecutively, we would generally schedule them around 6-8 weeks apart, to ensure the first side is healed and there are no issues before embarking on the second side surgery.
Risks
Bleeding, infection, recurrence, perforation of ear drum, pain in jaw joint (TMJ dysfunction), hearing loss, tinnitus, facial weakness, dizziness.
Predominantly using the chisel cuts these risks down as low as possible.