External auditory canal exostoses (or surfer's ear) are benign bony growths that form in the ear canal. These growths do not normally create any problems when they are small, however, they can grow to the point where water becomes trapped in the ear, causing outer ear infections. In the most severe cases, exostoses may block the ear canal completely, requiring surgery to recover natural hearing.
Exostoses are not uncommon for us to see in our Lindfield clinic, but if we were located next to a beach, we would probably see them every day. This is because of the strong link between exostoses and cold water.
Exostoses are believed to be the ear canal's reaction to repeated exposure to cold temperatures. Several Australian research studies show a high incidence of exostoses among surfers, with the condition tending to be more severe where the water is colder (e.g. Victoria compared to Queensland). Interestingly, there is also a tendency for surfers with exostoses to have the condition more severely in the ear that gets the most exposure to the wind. This is thought to be due to the cooling effect of the wind reducing the temperature even further, which could be the reason a recent study from Germany showed a higher prevalence of exostoses in wind- and kite-surfers than in regular surfers from the North and Baltic Sea areas.
In our earwax removal practice, patients usually present because of a blocked ear. Sometimes the cause of this symptom is severe exostoses, rather than earwax. Exostoses are easy to distinguish from a normal ear as you can see in the photo below.
Typically, a person with severe exostoses will find it difficult to completely clear their ear of water after surfing, swimming or showering and it is common for people with this condition to experience recurrent outer ear infections. Because of the very narrow opening left in the ear canal, outer ear infections can cause the canal to become swollen shut. Even normal earwax will easily create a complete ear blockage due to the narrow space between bony growths.
If exostoses are extensive enough to creating any of these issues, referral to an Ear, Nose and Throat specialist is always recommended. One of the advantages of having our practice in the Lindfield Specialist Centre is that we can usually arrange for you to see one of our co-located Ear, Nose and Throat specialists at short notice.