Surfer’s ear is the common term for external auditory canal exostosis, a slowly progressive condition where the bone within the ear canal develops abnormal growths. This benign bone overgrowth constricts the passage leading to the eardrum. It is particularly prevalent among cold-water athletes, such as surfers, divers, and kayakers, but it can affect anyone with prolonged exposure to the elements.
The Mechanism: How Exostosis Develops
Surfer’s ear is a reactive process where the body attempts to protect the delicate inner ear structures from environmental stress. Repeated exposure to cold water and wind are the primary triggers, stimulating the formation of new bone at the ear canal’s opening. This chronic irritation causes the bone-producing cells (osteoblasts) of the temporal bone to become overactive.
The result is the formation of multiple, broad-based, irregular bony lumps, known as exostoses, which grow inward. This growth occurs in the bony portion of the ear canal. Over many years, these growths gradually narrow the external auditory canal, a process that can take a decade or more to become noticeable.
The severity of the condition relates directly to the temperature and duration of cold-water exposure. As the ear canal narrows, its normal diameter of approximately 7 millimeters can be reduced significantly. This progressive constriction creates a physical blockage that impedes the normal drainage of water and earwax.
Recognizing the Signs: Symptoms and Progression
The earliest sign of exostosis is the sensation of water becoming easily trapped in the ear canal after water exposure. This trapped water struggles to drain past the bony constrictions and debris. While often asymptomatic in early stages, the growths eventually lead to more significant problems.
Trapped water and debris create a moist environment conducive to bacterial growth. This commonly leads to recurrent, painful outer ear infections, known as otitis externa. As the canal narrows, patients may also experience ear fullness, a chronic blocked sensation, or discharge.
Symptoms typically do not appear until the bone growth has significantly narrowed the ear canal. When the blockage becomes severe, it can cause a noticeable conductive hearing loss. A specialist diagnoses the condition using an otoscope to visually inspect the ear canal for the characteristic multiple bony lumps.
Surgical Intervention: Treatment Options
Surgical removal is the only definitive treatment once exostoses cause frequent infections, significant hearing loss, or persistent water trapping. This procedure, called an exostectomy or canalplasty, restores the ear canal to its original diameter. The goal is to carefully remove the bony growths while preserving the delicate skin lining the canal.
Surgeons may use a small micro-chisel or a drill to remove the excess bone. The drill technique sometimes requires an incision behind the ear for better access. The ear canal is packed with a dressing post-surgery to ensure the skin heals correctly over the newly widened bone. Full recovery, during which water activities must be avoided, usually takes between four and eight weeks.
Protecting Your Ears: Preventive Measures
Prevention focuses on protecting the ear canal from the cold water and wind that stimulate bone growth. Wearing specialized earplugs designed for water sports is the most practical and effective measure to create a barrier against the elements. Modern vented earplugs allow for sound transmission and pressure equalization while keeping the cold water out.
In cold or windy conditions, wearing a neoprene wetsuit hood or a specialized headband further reduces exposure to the irritants. After water exposure, it is important to thoroughly dry the ear canals to prevent water from remaining trapped. Tilting the head and gently pulling the earlobe can help trapped water drain out.
Some individuals use alcohol-based ear drops to help evaporate any residual moisture. Consistent use of these proactive steps is necessary because the bony growth can recur if cold water exposure continues unprotected.