Treatment

Do you need surgery ?

Usually, asymptomatic surfer’s ear lesion is no indication of surgery.

In my opinion, surgery is required in cases where repetitive external ear canal inflammation, difficulty in removing ear wax, and hearing loss due to ear wax accumulation, occur.

External ear canal skin has a very important function; a self-cleaning function. That’s why ear wax doesn’t accumulate on the ear drum and in the deep part of the external ear canal. Therefore removing the bony lesion while preserving the ear canal skin is important.

This picture shows the before and after of a surfer’s ear case.
It was taken when the operation was just finished and in this case, we could preserve the ear canal skin completely so there isn’t any exposure of the external ear canal bone.

Concerning the operation procedure, there are two major approaches to ear surgery. Generally, rear ear incision has been used for most ear surgery. But for external ear canal surgery, I prefer transcanal incision and some surfers also prefer this approach. Almost all avid surfers who require an operation for surfer’s ear, have exostoses in both of their ears. Transcanal approach is a less invasive procedure, thus recently it is becoming the new standard for this surgery.

How to remove bony lesion.

Chisel (Osteotome) technique for surfer’s ear surgery was introduced by Dr.Douglas G. Hetzler in 2007. In comparison with drilling techniques, the chisel technique for removal of ear canal exostoses has a number of advantages.

Unlike a drill burr, chisels pose little risk of damaging skin and can be used adjacent to and under intact skin.It enables surgeons to increase the preservation of the ear canal skin. There is the potential advantage of less risk of cochlear (inner ear) damage when using chisels to cleave bone compared with the noise generated by drilling in the ear canals of patients with normal hearing.

Usually this operation is undergone with general anesthesia, because the operation is unpleasant for patients, and the time is rather long. Usually, it takes about 60 – 90 min per ear to operate, depending on the degree of obstruction and the location of surfer’s ear.

Usually, I allow patients to start surfing 2 or 4 weeks after the operation.

Possible complications

Damaged ear canal skin, mastoid air cell opening, perforation of the ear drum, facial nerve palsy due to drilling heat damage, sensorineural hearing loss due to drilling noise, vertigo and tinnitus.