Those small, bony growths narrowing your ear canal may not just be an annoyance–they could be exostoses, commonly known as “surfer’s ear.” This condition, which develops gradually after repeated exposure to cold water and wind, can lead to water trapping, recurrent infections, and even hearing loss. We have formed a team of providers specially trained to diagnose and treat exostosis, helping Long Island patients maintain ear health and avoid complications from this progressive condition.
Our Expertise and Philosophy
At Integrative Ear, Nose and Throat, our team brings specialized expertise in diagnosing and treating exostosis. With advanced training in otolaryngology and recognition for clinical excellence, we understand the importance of both preventive measures and appropriate interventions for this condition.
Our philosophy emphasizes early detection and management of exostosis. While this condition develops gradually, addressing it before significant narrowing occurs can help avoid painful complications and preserve hearing. Our approach combines precise diagnostic techniques with minimally invasive treatment methods tailored to the severity of each case.
What Is Exostosis (Surfer’s Ear)?
Exostosis is a medical condition characterized by the development of benign bony growths (osteomas) within the external auditory canal. These growths form as a protective response to repeated exposure to cold water and wind, which stimulates bone growth in the ear canal. The condition is called “surfer’s ear” because it’s particularly common among surfers, but affects many water sport enthusiasts including swimmers, divers, kayakers, and sailors.
Unlike other ear conditions that may develop quickly, exostoses form very gradually over years of exposure. The bony growths typically develop as multiple lesions that protrude from the anterior, posterior, and sometimes inferior walls of the ear canal. As these growths enlarge, they can significantly narrow the ear canal diameter–from the normal 7-9mm to as little as 1-2mm in advanced cases.
Exostoses most commonly affect both ears, though the growths may develop asymmetrically. Clinical studies indicate approximately 80% of cases are bilateral. The condition occurs much more frequently in cold water environments–research shows individuals who engage in water activities in temperatures below 19°C (66°F) have a 600% higher incidence rate compared to those in warmer waters.
Common Concerns and Reasons Patients Seek Treatment for Exostosis
Patients with exostosis often experience several progressive symptoms that prompt them to seek medical care:
Water Trapping and Ear Fullness
As the ear canal narrows, water becomes trapped more easily during swimming or showering. This persistent sensation of fullness can be uncomfortable and frustrating, often lasting days after water exposure.
Recurrent Ear Infections
The narrowed canal creates an environment where moisture and debris accumulate, significantly increasing the risk of external otitis (swimmer’s ear). Studies show patients with moderate to severe exostosis experience 3-5 times more ear infections annually than those without the condition.
Progressive Hearing Loss
As exostoses grow, they can create a conductive hearing deficit by blocking sound transmission. This typically begins as intermittent hearing loss (especially when water is trapped) but can become permanent if the canal becomes severely occluded.
Pain and Discomfort
While the exostoses themselves are typically painless, the secondary infections and inflammation they cause can result in significant ear pain, particularly when pressure changes occur during flying or diving.
Interference with Water Activities
For avid water sport enthusiasts, the condition can significantly impact their ability to participate in activities they enjoy, affecting quality of life and recreational pursuits.
Concerns About Surgery
Many patients have heard that treatment requires surgery and seek expert care to understand their options and, when necessary, ensure the most advanced surgical techniques are used.
Our Customized Approach to Exostosis Treatment
Our team employs a comprehensive approach to managing exostosis, tailoring treatment to the specific stage and severity of each patient’s condition:
Advanced Diagnostic Assessment
Using specialized otoscopic examination and microscopic visualization, our specialist can precisely evaluate the location, size, and extent of exostoses. This detailed assessment allows for accurate staging of the condition from Grade I (mild narrowing) to Grade III (severe stenosis).
Preventive Counseling
For patients with early-stage exostosis or those at risk due to regular water exposure, our team provides customized prevention strategies. This includes recommendations for appropriate ear protection during water activities, such as custom-fitted earplugs specifically designed for water sports.
Conservative Management
For mild to moderate cases, we often begin with non-surgical interventions focused on preventing complications:
- Specialized ear cleaning techniques to remove trapped debris
- Protocols for water removal after exposure
- Management of associated conditions like external otitis
- Ear canal hygiene practices to prevent infection
Surgical Planning and Intervention
When exostoses cause significant narrowing or recurrent complications, we offer surgical intervention using the most advanced techniques:
- Transcanal approach (through the ear canal) when appropriate
- Precise removal of exostoses while preserving healthy ear structures
- Minimization of post-operative scarring and recovery time
- Comprehensive post-operative care to ensure optimal healing
Holistic Considerations
Our team also addresses factors that may influence exostosis management, including:
- Immune function assessment to reduce infection risk
- Evaluation of environmental factors that may accelerate growth
- Consideration of related conditions like temporomandibular joint disorders
Is Treatment Right for You?
Treatment recommendations for exostosis depend on several factors:
Extent of Canal Narrowing
Patients with significant narrowing (more than 50% of the canal diameter) may require intervention to prevent complications and restore normal ear canal function.
Symptom Frequency
Those experiencing recurrent ear infections (more than 2-3 per year) or persistent water trapping after swimming or bathing benefit most from medical or surgical treatment.
Degree of Hearing Impact
Measurable hearing loss attributable to exostoses often indicates the need for intervention, particularly when affecting communication or quality of life.
Activity Limitations
If exostosis is affecting your ability to participate in water sports or other activities you enjoy, treatment may significantly improve everyday comfort and recreational pursuits.
Rate of Progression
Evidence of rapidly growing exostoses may suggest the need for earlier intervention to prevent more extensive procedures that could be required in advanced cases.
During your consultation, our specialists will thoroughly evaluate these factors to determine whether conservative management or surgical intervention is most appropriate for your specific situation.
What to Expect During Your Evaluation
Your initial assessment for exostosis typically includes:
Comprehensive History
Our provider will discuss your symptoms, water sport participation history, previous ear problems, and specific concerns to understand the context of your condition.
Microscopic Ear Examination
Using high-powered microscopy, a member of our team will examine your ear canals to assess the extent, location, and characteristics of any exostoses. This precise visualization allows for accurate staging of the condition.
Hearing Assessment
A complete audiological evaluation may be performed to determine whether the exostoses are affecting your hearing and to establish a baseline for monitoring.
Treatment Planning Discussion
Based on the findings, the provider will explain your diagnosis, discuss treatment options, and develop a personalized plan addressing both immediate concerns and long-term management.
Frequently Asked Questions About Exostosis (Surfer’s Ear)
No, once formed, exostoses do not regress naturally. However, they typically grow very slowly, so early-stage cases may remain stable for years if cold water exposure is limited and proper ear protection is used.
Prevention focuses on protecting your ears from cold water and wind exposure. Custom-fitted neoprene or silicone earplugs designed for water sports are most effective. A neoprene hood or headband that covers the ears provides additional protection in very cold conditions.
No, but the risk increases significantly with frequent exposure to cold water. Studies show that approximately 70-80% of surfers who have engaged in the sport for more than 10 years in cold water regions show some degree of exostosis development.
Surgery is generally recommended only when exostoses cause recurrent problems like ear infections, significant water trapping, or hearing loss. Many cases can be managed conservatively, especially when diagnosed early.
Exostoses can recur if you continue cold water exposure without protection. Studies indicate recurrence rates of approximately 5-10% within 10 years for those who use consistent ear protection after surgery, but rates may exceed 50% for those who return to unprotected cold water activities.
While the hearing loss from exostosis is typically conductive and reversible with treatment, prolonged severe narrowing and associated chronic infections can potentially cause permanent damage if left untreated for many years.
Why Choose Integrative ENT for Surfer’s Ear Treatment
Surfer’s ear, or exostosis, involves bony growths in the ear canal that can cause hearing issues and repeated infections. At Integrative ENT, our specialized team has the training and experience to diagnose and treat this condition, focusing on minimally invasive solutions that protect your hearing and lifestyle.
- ENT specialists with proven expertise in exostosis evaluation and removal
- Personalized treatment plans, from monitoring to gentle surgical intervention
- Use of in-office and surgical techniques designed to preserve ear structure and function
- Team-based care to manage pain, recovery, and prevention of recurrence
- Patient-centered guidance on aftercare – especially for water sport enthusiasts
Whether you’re a recreational swimmer, surfer, or just spending time at the beach, our team is committed to helping you enjoy clear ears and clearer hearing all year long.
Expert Exostosis Treatment Throughout Nassau and Suffolk County
Whether you’re experiencing the early signs of surfer’s ear or dealing with advanced exostosis, our team provides specialized care tailored to your specific needs. With proper intervention, you can maintain ear health and continue enjoying water activities with appropriate protection.
With convenient locations in Syosset and Port Jefferson Station, expert care for exostosis is accessible to residents throughout Long Island. Contact our office today to schedule your consultation and take the first step toward optimal ear health.