Surfer's Ear

September 14, 2005
Colin M. Feeney, MD
Colin M. Feeney, MD

A 35-year-old man, a sea and white-water kayaking instructor, complained of pain and congestion in the right ear. Otoscopy revealed bilateral external auditory canal stenosis with impacted cerumen and otitis externa on the right.

A 35-year-old man, a sea and white-water kayaking instructor, complained of pain and congestion in the right ear. Otoscopy revealed bilateral external auditory canal stenosis with impacted cerumen and otitis externa on the right. Dr Colin M. Feeney of Oakland, Calif, diagnosed this condition as surfer's ear, or exostoses of the external auditory canal. This post-treatment view shows three exostoses (arrows) that-before treatment-had completely occluded the tympanic membrane (TM).

Surfer's ear is a localized hyperplasia of compact bone at the tympanic ring, which, unlike an osteoma, is symmetric and bilateral. It may occur after at least 5 to 10 years of exposure to water cold enough to produce prolonged vasodilatation and subsequent new bone formation. Treatment includes avoidance of the cold water and surgical intervention.