Surfer’s Ear (Exostoses)

• Exostoses of the external auditory canal, colloquially known as Surfer’s ear are bony growths of the ear canal thought to be due to a periosteal reaction to cold water (refrigeration periostitis).¹
  • Exostoses are strongly associated wiith the frequency and severity of exposure to cold water, and are hence more commonly seen with swimmers, surfers, kayakers, or others with frequent cold water exposure.
  • Clinically, they will present as broad-based, typically bilateral growths that occur more medially in the ear canal, often near the tympanomastoid or tympanosquamous sutures.
• Surgical removal of exostoses is typically only reserved for patients with conductive hearing loss due to debris impaction, recurrent infections, or if they are unable to fit a hearing aid.
• See our image atlas for more examples.

• Exostoses differs from an ear canal osteoma, which is usually pedunculated, solitary, and more laterally based in the ear canal.
• Unlike exostoses, an osteoma is not associated with a history of cold water exposure and is a true neoplasm.

Exostoses versus Osteomas of the Ear Canal