Surfer’s
Ear
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Surfer’s Ear is the name
for the bony growth that occurs in the ear canal
after cold water exposure and it can lead to
hearing loss, recurrent infections or ear canal
obstruction.
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Since
the April Tax Day looms, how about reciting the things
in life you can always count on? Well, taxes? Your Mum?
Getting burned surfing Los Angeles on a Sunday? What
else can you count on? Traffic on the 405, at least
two parking tickets a year; Britney Spears weighing
2 bills in 2 years? Here is one more item you can count
on if you surf: External Auditory Canal Exostoses also
called Surfer’s Ear.
Surfer’s Ear is common in lovers of water activities
and this is especially true for surfers. That part of
the ear you stick your finger in when sitting in the
405 traffic is called the external auditory canal. With
Surfer’s Ear, cold water exposure causes multiple
thick bony lesions to protrude into this canal. Most
often these lesions are asymptomatic, however Surfer’s
Ear can cause recurrent ear infections, irritation,
or even hearing loss.
If you hold it up to your
ear you can hear the ocean...
shots by alizafotography.com
Why
is Surfer’s Ear like taxes? If you spend time
in the water, you will have to pay your dues. The medical
research supports my guarantee. The Archives of Otolaryngology-
Head and Neck Surgery in 1999 examined the ears of 307
surfers and 73.5% had some form of Surfer’s Ear.
In the group that surfed less than 10 years, 44.7% had
normal ear canals and 6% had severely obstructed canals.
And for the old timers, the group that surfed longer
than 20 years, 9.1% had normal ear canals and 16.2%
were severely obstructed. At least you are not a daily
Maverick’s or Ghost Tree charger; surfers in Northern
California develop significant obstruction twice as
quickly as Southern California surfers due to the colder
water. A 2002 manuscript in the same journal showed
that Californian Surfers are 5.8 times more likely to
develop Surfer’s Ear than their Hawaiian counterparts;
this increased incidence is related to the colder water.
Need more proof? Let’s refer to one reader’s
email:
“I am a 55 year old surfer from LI, NY...been
surfing since '69. I am in very good ‘surfing
shape’, ie: double sessions, even in winter, and
I ride a 7'6" thruster when conditions warrant.
I surf an average of 130 days per year. I have had three
"surfer's ear" operations (one BAD, one good
revision, & one very good one).” –G.S.
This writer is an old timer; beware of him. When he
burns you on the “7’6 thruster” and
you scream at him, he really can’t hear you because
of his Surfer’s Ear. (Editor’s note: ‘thruster’
is a 1980’s term used to describe a short board.
The use of this term correlates highly with age greater
than 50 years and a New York background). Forgive him,
the Surfer’s Ear odds have caught up with him
after decades of surfing. With a little prompting though,
GS can teach us all about Surfer’s Ear.
“I had NO infection, hearing loss, or other problems.
However, 3 different Ear, Nose and Throat doctors told
me my canals were 99% closed, and that waiting could
allow an infection to occur, which would extremely complicate
the surgery. I went with a local Dr. who claimed to
have much experience with this surgery, but mainly because
he was on my medical insurance plan...BIG MISTAKE. Fast
forward to the operation---he drilled for 6(!) hours,
and later claimed he "lost his way" and blew
a hole in my eardrum that required a second surgery--obviously
by a different surgeon, to be repaired artificially.
I have had constant tinnitus in my right ear, along
w/ a substantial hearing loss. I'll spare you the details
of the anguish I went through during this time--both
physical and emotional--and just say that it was Dr.
P at Manhattan Eye & Ear who "fixed" things,
and he performed the surgery on my left ear, as well,
with NO problems at all. I get the ears checked &
cleaned (no more natural flushing in the right ear)
every 6 months.” –G.S.
Can you hear me now?
shots by alizafotography.com
The
email brings up a number of points about the treatment
for Surfer’s Ear. The decision to proceed with surgery
for Surfer’s Ear is not straightforward. In 2003
the Journal of Otolaryngology reviewed the operations
for 182 patients with Surfer’s Ear. Only 67% of
the patients had a relief in symptoms, 14% had complications
such as tympanic membrane perforation, infection or hearing
loss, and 6% required reoperations. These percentages
support GS’s conclusion: if you are like most surfers
who develop External Auditory Canal Exostoses without
symptoms (hearing loss, recurrent infections, or canal
obstruction) then you should delay surgery until symptoms
develop. If you decide to precede, extensively research
the surgeon you choose. Question to ask include: “how
many of these surgeries do you perform a year, what complications
have you had, will monitoring my disease affect my outcome,
and have you published your results?”
What can you do to avoid the surgeon’s steel? Well
you already know…. and don’t pretend the Surfer’s
Ear made you deaf, you are reading this. Put the plugs
in your ears; a 2004 study in Clinical Otolaryngology
noted the plugs prolonged the time for Surfer Ear’s
to develop by a factor of 5. If you compare this study
to the one above, a Californian with plugs develops Surfer’s
Ear at about the rate of a Hawaiian without plugs. And
nobody will call you a “Haole”.
Surf
Safe!
Dr. Jude
Email Dr.
Jude with your questions and
comments
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