Ear exostosis, commonly referred to as Surfer’s Ear, is a condition where bony growths form in the ear canal. It is typically caused by repeated exposure to cold water and wind, which triggers new bone formation as a protective response.
These bony lumps gradually narrow the ear canal, and although they are not cancerous, they can lead to hearing loss, trapped water, wax build-up, and recurring ear infections. The condition is especially common in surfers, divers, kayakers, and other water sport enthusiasts—hence the name.
Exostosis usually develops slowly over many years and may affect one or both ears. Treatment is not always necessary, but in more advanced cases, surgery may be recommended to remove the excess bone.
The exact cause of exostosis is prolonged cold water exposure, especially in combination with wind. It is believed that the cold stimulus causes repeated inflammation and stimulation of the bone lining (periosteum), leading to new bone formation.
Risk factors include:
Exostosis differs from osteomas, which are usually solitary benign bony growths of unknown cause. Exostoses are multiple, broad-based, and more directly linked to environmental factors.
In early stages, exostosis may not cause any symptoms and is often found incidentally during an ear examination. As the bony growths enlarge, they can narrow the ear canal, leading to:
If infections occur, symptoms may include pain, discharge, itching, and swelling of the ear canal.
Exostosis is diagnosed by an ENT specialist through an otoscopic examination, where the narrowed bony canal is visible. Additional tools may include:
If exostosis is mild and not causing symptoms, no treatment may be required. However, preventive strategies are important:
Avoid inserting cotton buds or other objects into the ear, as this may worsen irritation or cause infection.
When exostosis causes significant canal blockage, frequent infections, or hearing problems, surgical removal of the bone growths (exostectomy) may be recommended.
Key points about Exostectomy:
Surgery is generally effective, but continued water exposure without protection can lead to recurrence over time.
Preventing exostosis is key, especially for water sport enthusiasts:
These steps can help reduce irritation and prolong the time before surgical treatment might become necessary.
After surgical removal or diagnosis of ear exostosis:
No. Surfer’s ear (exostosis) is a bony growth due to cold water exposure. Swimmer’s ear (otitis externa) is an infection of the ear canal. However, surfer’s ear can increase the risk of swimmer’s ear due to water trapping.
No. Once bone has formed in the ear canal, it does not regress. Mild cases can be monitored, but surgery is the only way to reverse significant narrowing.
Exostosis can slowly recur if cold water exposure continues. Wearing protective plugs or caps can greatly reduce the risk of recurrence.
Surgery may be considered if exostosis causes:
• Frequent infections
• Water trapping
• Hearing loss
• Difficulty with ear cleaning
Your ENT specialist will discuss the pros and cons based on your individual case.
If you’d like to discuss a procedure or explore suitable treatment options, please get in touch with Dr Nicholas Phillips’ clinic.
To book with Dr Phillips, you’ll need a referral from your GP or specialist. Questions? Call our team — we’re happy to help.
