SURFERS EAR MYTH BUSTERS

By Corky Carroll

It’s that time of year for my annual visit to the wonderful world of “SURFERS EAR,” the laypersons term for EXOTOSIS.  This is a boney growth in the outer ear canal that is very common with surfers in our area, the beauteous Orange County.  My super expert on this subject is the leading doctor on the planet, and beyond, on this subject, Dr. Carol Jackson from Newport Beach.  I asked Dr. Jackson for an update on what is currently going on with this extremely not fun to have ailment and she sent me the following info:
 
“I’m often asked about certain notions about exostosis which is known as surfer’s ear.  Some are outdated or simply wrong.  Exostosis is the ear canal blockage from years of cold water pounding against the ear drum.  The benign bony grows begin as small speed bumps then enlarge. Canal occlusion of more than 80% leads to ear plugging and low grade then painful acute infections. It’s preventable by wearing ear plugs in the surf.
 
Myth:   Using isopropyl alcohol ear drops whenever I’m in water will keep my ears healthy.
Wrong. Alcohol is too drying for frequent use.  It removes protective skin oils, causes dryness and cracked skin leading to infection.
 
Myth:   Wearing ear plugs when surfing will throw my balance off.
No, although some surfers feel reduced spatial awareness or even mild claustrophobia. However, membrane ear plugs or those with small vents can help and also allow better hearing when worn.
 
Myth:   Having my exostoses removed will make them grow back like weeds.
Incorrect.  The growth rate depends on individual susceptibility for which there is a bell curve for individual susceptibility plus cumulative hours of unprotected ear pounding by cold water.
 
Myth:  Once my exostoses are removed, I’ll need them removed again every few years.
Not true.  If repeat removals are needed, the exostoses were probably not completely removed. With total removal, particularly with laser, re-growth to needing removal doesn’t occur for fifteen or more years. Wearing ear plugs prevents or arrests exostosis.  See an ear specialist, otologist, who uses a microscope for your ear care and can show you your exostosis, canal, and ear drum on a monitor screen. You may request photos of your ear.
 
Myth:  My surfer’s ears didn’t develop until I took up SCUBA diving and wind surfing after 20 years of surfing which I had stopped.
Unlikely.  Most patients with exostosis have a substantial surfing history.  It’s forcible flushing of cold water against the ear drum that is the strongest stimulus for exostosis formation.  Cold air and gentle flow of cold water in the ear are highly unlikely to stimulate large exostoses.

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Myth:  Ear wax is dirt I should clean with Q-tips or over the counter wax removers.
Wrong.  Cerumen is nature’s water-repellent moisturizer over thin ear canal skin.  It is protective; like wax on a surfboard. The ear is self-cleaning unless it’s too dry or gets trapped in ear canal irregularities, as with surfer’s ear. Over the counter agents have drying chemicals and can result in ear swelling or flushing wax deeper.  I recommend baby or other prescription oils.
 
Myth:  When water won’t come out of my ear, I should use Q-tips or alcohol.
Incorrect.  Use an air blow dryer to evaporate the water while preserving the moisturizing oils.
 
Myth:  Exostosis removal requires an incision and scar behind my ear.
No longer true.  With the technique I developed and have used for many years, exostoses are completely and safely removed through ear canal incisions which, with local grafts, reduce healing time.
 
Myth: Surfer’s ear surgery is painful.
No, it usually is not.  More than 90% of our patients are comfortable taking Tylenol, ibuprofen or nothing for postoperative discomfort.
 
Myth: Surfer’s ear causes permanent hearing loss.
Not usually.  Plugged hearing that occurs in surfer’s ear is usually temporary and due to retained debris, infection, foreign bodies including sand, exostosis, and swelling. Of course, it can add to other causes of hearing reduction and with advanced exostosis, the column of water forced to the ear drum with falling into waves, can be traumatic, like noise, and add to hearing loss.
 
Surfers may also have reduced hearing due to hereditary and other factors, noise exposure and age over 60, which is not be improved with exostosis care. With today’s improved technologies, affordable hearing instruments help over 90% of wearers when amplification and improved speech clarity are needed. Many models are rechargeable and can link to TVs or cell phones.
 
For a baseline or an ear problem if you enjoy surfing or have ear concerns, it’s prudent to see an experienced ear doctor with an office microscope. Also, have a hearing test in a sound-treated booth by an audiologist or hearing professional. If you take care of your ears and health, you could enjoy surf sports into your 80’s and 90’s like some of our patients!”
For contact with Dr. Jackson and more info go to www.myeardoctors.com

Surfers Ear Article