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Prevalence of External Auditory Canal Exostoses in Surfers
Brian J. F. Wong, MD;
William Cervantes, MD;
Karen Jo Doyle, MD, PhD;
Amir M. Karamzadeh;
Phillip Boys, MD;
George Brauel, MD;
Ednan Mushtaq, MD
Arch Otolaryngol Head Neck Surg. 1999;125:969-972.
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 ≤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.
From the Department of Otolaryngology–Head and Neck Surgery and the Beckman Laser Institute and Medical Clinic, University of California at Irvine (Dr Wong and Mr Karamzadeh); and the Department of Head and Neck Surgery, University of California at Davis, Sacramento (Dr Doyle). Dr Cervantes is in private practice in Kailua-Kona, Hawaii. Dr Mushtaq is in private practice in Falls Church, Va. Dr Boys and Dr Brauel are deceased.
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