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What is Exostosis? (A.K.A Surfer’s Ear)

Exostoses are bony growths in the ear canal that result from repeated or prolonged exposure to cold ocean water.

Wong and colleagues[1] surveyed and examined three hundred and seven surfers and found that 73.5% of them exhibited some degree of exostosis. They further found that those surfers who were involved in the sport for 20 years or more, had a higher prevalence of exostosis compared to surfers who had been surfing for less than ten years.

Research has found that the temperature of the water has a significant effect on the development of exostosis. For example, swimmers and surfers who were exposed to colder temperatures of the North Pacific Ocean were more likely to develop exostoses earlier in their life compared to those being exposed to the warmer water temperatures of the ocean in Southern California[2]. However, surfers and swimmers in Southern California are still at a great risk to develop exostoses if frequently exposed to ocean water.

Exostosis remains asymptomatic in its early stages. After repeated exposure to cold water, the growths can get bigger to the point where they start to block the ear canal. This can lead to water getting trapped behind the growth and becoming infected causing outer ear infections which require medical treatment. In more severe (yet common) cases, the exostosis can completely block the ear canal causing hearing loss. Once the exostosis grows to the point of causing infections or hearing loss, surgical intervention is required to open the ear canal.

The best way to prevent the development or progression of exostosis is to use earplugs while swimming or surfing in ocean waters. At ChEARS Hearing Center, we offer custom earplugs for surfers and swimmers. The process is simple – we take a cast of the ear canal by inserting impression material in the ears, then that cast is used to make earplugs that have a custom fit for your ears. We invite you to call our office and make an appointment to find out more about our custom earplug solutions and begin taking care of your ears today!


1 Rick, a ChEARS patient and avid surfer using his custom earplugs while surfing in San Diego.  


[1] Wong BJF, Cervantes W, Doyle KJ, Karamzadeh AM, Boys P, Brauel G, Mushtaq E. Prevalence of External Auditory Canal Exostoses in Surfers. Arch Otolaryngol Head Neck Surg. 1999;125(9):969–972. doi:10.1001/archotol.125.9.969

[2] Deleyiannis  FWCockcroft  BDPinczower  EF Exostoses of the external auditory canal in Oregon surfers.  Am J Otolaryngol. 1996;17303- 307