External auditory canal exostoses

Last revised by Arlene Campos on 3 Jan 2024

External auditory canal exostoses, also known as surfer's ear, are benign bony overgrowths of the bony external auditory canal brought about by exposure to cold wind and water combined.

The estimated prevalence in cold-water surfers is thought to range between 70-80% 5,6,8.

Patients may be asymptomatic or present with cerumen impaction, conductive hearing loss and/or otitis externa 8.

Exostoses develop from prolonged irritation of the external auditory canal, typically with repeated cold-water exposure, which is thought to stimulate new bone formation at the tympanic ring within the external auditory canal 8. Exostoses have also been reported to occur after warm-water exposure 7.

  • broad-based or more focal circumferential bony overgrowth of the osseous external auditory canal

  • bilateral in many cases

Wearing ear plugs or hoods while in cold-water can reduce the occurrence and/progression of exostosis 8. Canalplasty may be required in cases where complications (hearing loss, infection) has occured 8.

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