Surfer's Ears

Overview

Surfer's ear is a condition where the bone of the ear canal develops multiple bony growths called exostoses. Over time, this can eventually cause a partial or even complete blockage of the ear canal.

You may reference the Anatomy of the Ear page for better understanding of the anatomy.

Presenting Symptoms

Surfer's ear usually presents with an infection of the ear canal or blockage of the ear canal and hearing loss.

Causes

Prolonged exposure to cold water and wind are the cause of Surfer's ear. Cold water surfers are 6 times more likely to get Surfer's ear than warm water surfers. 

Complications 

When the ear canal is narrowed, water and debris can get trapped behind the narrowing causing infection. These infections of the ear canal (external otitis) are also called Swimmer’s ear. The infections are more difficult to treat in people with surfer’s ears than those with open ear canals. The treatment of the infection will require several visits to an ear nose and throat physician for cleaning of the debris and antibiotic treatment. Once over 90% of the ear canal gets blocked, a significant hearing loss will occur, which can only be relieved by removing the exostoses. 

Treatment 

The only way to treat Surfer’s ears definitively would be to remove the bony growths (exostoses). The procedure is most commonly performed through the ear canal and a combination of micro chisels and small drills are used to remove these bony growths. The drill is only used for the growths that are close to the ear drum. This is because use of the chisel close to the ear drum increases the chance of getting a hole in the ear drum from the surgery. If the bony growths extend close to the ear drum, the surgery is may be done from behind the ear (incision behind the ear). The procedure is done on an outpatient basis (patients go home the same day). The recovery period is at least a month. During this time period, water should not enter the ear canal – meaning no swimming or surfing. If ear plugs are not worn after the ear canals have healed (after surgery), the bony growths can return. It will take several years for that to occur, but it will probably occur. The best treatment is prevention. 

Laser Removal of Surfer Ears

A note about "laser" treatment of surfer ears. Lasers are useful for evaporating tissue or cutting soft tissue (such as scar tissue). They work by creating a very high temperature at the tissue level which evaporates the tissue. The use of the laser for removal surfer ears is not appropriate as lasers cause burning and destruction of bone. When the bone is burned it dies. The skin of the ear canal will not heal on dead bone, which causes a prolonged healing process. On occasion, these patients will need a second surgery to remove the dead bone and the placement of skin grafts to help the healing process. We strongly recommend against the use of lasers for surfer ear removal.

Dr. Djalilian's Surgical Philosophy:

At UC Irvine, nearly all patients have their surgeries performed through the ear canal and are done using the micro-chisels, even with 100% obstruction. We generally avoid using the drill except for rare special cases. While in the past years, we have made an incision behind the ear, currently, it is rare that we do it from behind. It is also rare that we need to get a skin graft to cover the ear canal skin. Using the method through the ear canal and using the chisel, the normal ear canal skin is nearly always preserved so it is not necessary to get a skin graft. The ear canal generally heals within 3-4 weeks and rarely up to 6 weeks.

Click below for a video of surgical removal of surfer ears.

Prevention 

The best method of treatment is using ear plugs when surfing. Other methods of prevention include using a hood or a special headband that covers and seals the ears. The best combination is using ear plugs and a headband or hood.

Why Come to UC Irvine?

At UC Irvine, we strive to treat the our patients with the latest and best techniques to insure a faster recovery and return to normal activities. In addition to the routine exostoses cases, Dr. Djalilian receives the referrals from the most complex patients with severe disease and has extensive experience with surgeries not generally performed by other surgeons. We also are one of the very few centers where the surgery can be done entirely through the ear canal and using the microchisel.

To Make an Appointment with our ear specialist, Dr. Djalilian, Please Call 714-456-7017 or click here to request an appointment via the web.