Prevalence of external auditory canal exostoses in surfers

Arch Otolaryngol Head Neck Surg. 1999 Sep;125(9):969-72. doi: 10.1001/archotol.125.9.969.


Objective: To determine (1) the prevalence of external auditory exostoses in a population of surfers and (2) the relationship between the length of time spent surfing and the prevalence, severity, and location of the exostoses.

Design: Cross-sectional epidemiological study.

Setting: General community.

Patients: Three hundred seven avid surfers (93.5% males and 6.5% females; age distributions: 11.2% were < or =20, 67.9% were 21 to 40, 17.5% were 41 to 50, and 3.3% were >50 years).

Main outcome measures: Questionnaires focusing on surfing habits (number of years, geographic region, and number of days per year of surfing) were correlated with otoscopic findings. A simple grading system was devised, based on the degree of external auditory canal stenosis. Grades of normal, mild, moderate, and severe corresponded to 100%, 99% to 66%, 65% to 33%, and less than 33% effective patent surface area, respectively.

Results: There was a 73.5% overall prevalence of external auditory exostoses and a 19.2% overall prevalence of osteomas in the group studied. Of 441 ears with exostoses, 54.2% were mild, 23.6% were moderate, and 22.2% were severe. Of individuals who had surfed for 10 years or less, 44.7% had normal ear canals and only 6% had severely obstructed auditory canals. In comparison, in the group that had surfed for longer than 20 years, only 9.1% had normal auditory canals and 16.2% were severely affected. Of surfers with no exostoses, 61.1% had surfed for 10 years or less. In contrast, of surfers with severe exostoses, 82.4% had surfed for more than 10 years. Finally, the lesions seemed to affect all external auditory canal quadrants equally.

Conclusion: A positive association exists between the amount of time individuals spend surfing and the presence and severity of exostoses of the external auditory canal.

MeSH terms

  • Adult
  • Athletic Injuries / etiology*
  • California
  • Cold Temperature / adverse effects
  • Ear Canal / injuries*
  • Endoscopy
  • Exostoses / etiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Swimming / injuries*