Ear canal exostosis

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Classification according to ICD-10
H 61.8 Other specified diseases of the external ear

Exostosis in the external ear canal

ICD-10 online (WHO version 2019)

An auditory canal exostosis ( also known as surfer's ear in English ) is a formation of compact bone substance ( exostosis ) that occurs in the external auditory canal ; a single cancellous osteoma is differentiated from multiple, compact exostoses. They sit broadly on the bone. Their origin lies in the sutura petrotympanica and tympanomastoidea, the cranial sutures of the os tympanicum to the pars petrosa and squamosa of the temporal bone . Harrison differs in etiology , the exostosis of osteoma, while the clinical picture of osteoma should be used only for those bony tumors that have arisen without a triggering cause.


Ear canal exostoses. View into the narrowed outer ear canal with the otoscope .
For comparison: outer ear canal without changes

Ear canal exostoses are not uncommon among surfers : in a New Zealand study they were detectable in 73% of the examined athletes; in 40% of the examined, the narrowing of the ear canal was more than 50%. A comparable frequency ( prevalence ) has also been reported in California surfers. Ear canal exostoses can also occur in other water sports such as white water paddling or apnea diving .

Clinical picture and causes

Often it is an asymptomatic incidental finding during otoscopy . However , ear canal exostoses can become symptomatic due to ear canal inflammation , hearing loss , ringing in the ears or obstruction of the ear canal due to ear wax .

This is probably due to a multifactorial process, but in particular the penetration of cold water into the external auditory canal represents a growth stimulus for the adjacent bone tissue.

Treatment and prevention

Multiple ear canal exostoses

An endaural or retroauricular approach can be selected for the surgical removal of exostoses . Since the surgical treatment of exostoses is often associated with complications, the indication for surgery is made according to strict criteria. Surgery will only be carried out if symptoms such as recurrent ear canal inflammation occur on a regular basis.

For prevention ( prophylaxis ), special earplugs are offered for water sports enthusiasts . Whether such earplugs can prevent the development of ear canal exostoses has not been proven by scientific studies. In a study of the postoperative long-term course of water sports enthusiasts with symptomatic auditory canal exostoses, however, the use of earplugs was associated with a reduced recurrence rate .


In the hooded seal (Cystophora cristata) living in arctic waters, exostoses of the ear canal are physiological and contribute to the protection of the auditory organ .

Literature and Sources

  • Mlynski et al. a .: Exostoses of the external auditory canal. In: ENT. 2008; 56, pp. 410-416. PMID 17851642

Individual evidence

  1. Jürgen Strutz, Wolf Mann: Practice of ENT medicine, head and neck surgery. Georg Thieme Verlag, 2010, pp. 249–250.
  2. ^ R. Mlynski, A. Radeloff, K. Brunner, R. Hagen: Exostoses of the external auditory canal. In: ENT. (2008); 56 (4), pp. 410-416.
  3. ^ DF Harrison: The relationship of osteomata of the external auditory meatus to swimming. In: Annals of the Royal College of Surgeons of England. (1962) (31), pp. 187-201.
  4. ^ Chaplin & Stewart: The prevalence of exostoses in the external auditory meatus of surfers. In: Clin Otolaryngol Allied Sci. 1998; 23, pp. 326-330. PMID 9762494 .
  5. Wong et al. a .: Prevalence of external auditory canal exostoses in surfers. In: Arch Otolaryngol Head Neck Surg. 1999; 125, pp. 969-972. PMID 10488981
  6. ^ Cooper et al. a .: External Auditory Canal Exostoses in White Water Kayakers. In: Br J Sports Med. 2008 Jul 4. ([Epub ahead of print]) PMID 18603582
  7. Sheard & Doherty: Prevalence and severity of external auditory exostoses in breath-hold diverse. In: J Laryngol Otol. 2008; 122 (11), pp. 1162-1167. PMID 18346299
  8. a b Mlynski u. a .: Exostoses of the external auditory canal. In: ENT. 2008; 56, pp. 410-416. PMID 17851642 .
  9. Kroon et al. a .: Surfer's ear: external auditory exostoses are more prevalent in cold water surfers. In: Otolaryngol Head Neck Surg. 2002; 126 (5), pp. 499-504. PMID 12075223
  10. Ito & Ikeda: Does cold water truly promote diver's ear? In: Undersea Hyperb Med. 1998; 25 (1), pp. 59-62. PMID 9566088
  11. Timofeev et al. a .: Exostoses of the external auditory canal: a long-term follow-up study of surgical treatment. In: Clin Otolaryngol Allied Sci. 2004; 29, pp. 588-594. PMID 15533142
  12. Stenfors u. a .: Exostoses and cavernous venous formation in the external auditory canal of the hooded seal as a functional physiological organ. In: Acta Otolaryngol. 2000; 120 (8), pp. 940-943. PMID 11200588

Web links

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