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TO PLUG, OR UNPLUG…..THAT IS THE QUESTION

12/3/2022

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by Corky Carroll
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​It’s that time of year again where the water and air are getting colder and Orange County surfers are taking measures to stay warm.  One of the common problems with being in, and on, the ocean and exposed to wind and weather is the growth of what we call “surfers ear.” Luckily right here in Newport Beach we have one of the most renowned Ear Doctors and the leader in the field of treating surfers ear.  Dr. Carol Jackson.  She is THE go to person if you are having issues with your ears.  She has taken great care of me, I can testify to that. Each year at this time I ask her to give us an update on the latest in ear care for surfers.  She just sent me the following.
 
““I can’t get my ear to unplug or stay unplugged!” is the familiar expression of surfing enthusiasts when benign boney nodules called exostoses enlarge over years to block over 80% of the eardrum.  They interrupt the ear’s normal self-cleaning and protective wax mechanisms. Instead, infectious material, sand, and dead skin plug the ear by clinging to the exostoses and won’t flush off. This scenario can progress to an acute infection, “swimmer’s ear,” that can cause the severe pain that makes a grown man cry.  That’s when it’s time to see an ear doctor for removal of the material, treatment, and stepped-up prevention. When blockage is over 85%, it’s time to consider getting them removed.

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Laser-assisted microsurgical excision is minimally invasive and outpatient. It’s now more complete and safer than ever and it’s essentially painless.  External skin incisions are no longer necessary so there are no visible scars. Gone is the postop period of the ear protruding and numbness of the pinna.  With eighteen-year follow-up, exostoses do not re-grow to require repeat surgery at all.  It’s a permanent solution to put “surfer’s ear” in the rearview mirror. Usual non-water activities can be resumed the next day.  Usual return to water with precautions is in four to six weeks.
 
Exostosis can be halted or prevented altogether by use of ear plugs while surfing.  Shallow plugs or disposable silicone ones at drug stores and sporting goods retailers work well if they fit comfortably and keep most of the water out. The forcible rush of cold water in the ear is the main stimulus for exostosis. Best are custom plugs made from a mold impression of your canal. Now they can be ordered with a tiny membrane-covered vent that allows sound through. They last years, float, come in bright colors even with glitter, and can be on a lanyard. Rarely are they lost in the surf! 
 
If you sense plugging or it seems like some people mumble, you could have reduced hearing related to surfer’s ear or unrelated such as prior loud sound or head trauma. Surfers with ringing in the ear or dizziness may have unrelated ear issues needing separate tests and treatment such a benign acoustic neuroma or elevated inner ear fluid pressure, called hydrops.  You can have more than one cause of ear problems at the same time, 17and they can be different in ear each.
 
Learn about the severity of your exostosis on camera and receive an ear checkup.  It’s wise to see an ear doctor who uses an office microscope and can show your ear image for you to see and understand. Have a hearing test by a hearing pro in a sound booth.
 
At home, if you want to try to ease mild itching, discomfort, or plugging you can try instilling and massaging in a few drops of original plain baby oil while lying on your side with the affected ear up twice a day keeping the ear clean and dry.  Don’t use over-the-counter preparations, swabs or flushing due to the risk of pushing material deeper or causing more swelling from irritating chemicals. Isopropyl alcohol can sting and make inflamed skin dry and crack, making matters worse.
 
It's clear that keeping unhealthy ears dry is key especially when you suspect water in the ear canal or get moisture or drainage.  Remove water by evaporation; not swabs or Kleenex which wick out protective skin oils. A hair dryer for three minutes is helpful yet there are special ear dryers online. They’re portable, plug into vehicle power ports and work on batteries. Germs cannot live in the ear without water. No water, no bacteria or fungus!
 
Just as with eyes and vision, your ears and hearing need conscientious care, too” 
 
To contact Dr. Jackson’s Ear & Balance Clinic and for more info visit www.myeardoctors.com
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