Protect Your Ears: Preventing Surfer's Ear

Western Australia is a haven for water sports enthusiasts,  with its pristine water, raw coastline and breathtaking scenery. However, this region presents a common problem for surfers known as surfer's ear. The cold water and wind increase the risk of developing external auditory exostosis (EAE), commonly referred to as surfer's ear. In this article, we will explore the process, prevalence, risk factors, diagnosis, and treatment of surfer's ear, as well as highlight the importance of preventative measures and the impact on public health.

 

Question 1: What is surfer's ear?

Surfer's ear, or external auditory exostosis (EAE), is a condition characterised by the growth of benign bony outgrowths in the ear canal. It is commonly observed in surfers and individuals engaged in other aquatic sports.

 

Question 2: What is the clinical presentation of surfer's ear?

Surfer's ear may initially be asymptomatic. However, as the condition progresses, individuals may experience a blocked feeling in the ears, frequent water trapping, chronic cerumen impaction, recurrent otitis externa (ear infections), otalgia (ear pain), and conductive hearing impairment.

 

Question 3: What is the prevalence of surfer's ear in surfers?

The prevalence of surfer's ear among surfers is high, ranging from 38% to 80% based on otological examinations. In some studies, severe grades of EAE were observed in more than 50% of male surfers.

 

Question 4: What are the pathophysiology and etiology of surfer's ear?

The exact mechanisms behind the development of surfer's ear remain unknown. However, exposure to cold water and air is believed to stimulate bone growth in the ear canal as a protective response to low temperatures.

 

Question 5: What are the risk factors of surfer's ear?

The primary risk factors for surfer's ear include the amount of time spent in the water and exposure to cold water and wind. Individuals who surf frequently, especially for more than five years, are at a higher risk of developing surfer's ear.

 

Question 6: How is surfer's ear diagnosed?

Surfer's ear is diagnosed through an otoscopic examination, which involves visually identifying the bony outgrowths in the ear canal.

 

Question 7: What are the differential diagnoses of someone suspected of having surfer's ear?

Differential diagnoses for surfer's ear may include osteoma, squamous cell/glandular cell carcinoma, benign glandular tumors, cholesteatoma, and other conditions affecting the temporal bone.

 

Question 8: Is surfer's ear preventable?

While the feasibility of preventing surfer's ear remains uninvestigated, there are several preventative measures individuals can take. Regular use of earplugs, hoods, or hats that cover the ears can help reduce exposure to cold water and wind. Avoiding surfing in extremely cold or windy conditions is also recommended.

 

Question 9: What is the treatment of surfer's ear?

The definitive treatment for surfer's ear is surgical removal of the bony growths. However, this is typically reserved for severe and symptomatic cases, as the procedure carries risks of complications and does not guarantee prevention of recurrence.

 

Question 10: When is it appropriate to refer a patient with surfer's ear to a specialist?

Referral to an otorhinolaryngologist is recommended for large lesions (Grade 3), recurrent ear infections, progressive hearing loss, suspicion of another diagnosis, or when symptoms are not consistent with clinical findings. An audiogram should be organized prior to referral.

 

Surfer's ear, or external auditory exostosis, is a common problem faced by surfers in the South Coast of Western Australia due to the cold water and wind. This condition can lead to significant discomfort, water trapping, and even serious health issues if left untreated. While surgical intervention is available for severe cases, prevention is key in safeguarding the ears of surfers, divers, kitesurfers, windsurfers, SUPers etc.

 

By taking simple preventative measures such as wearing earplugs, hoods, or hats that cover the ears, surfers can reduce their risk of developing surfer's ear. While the loss of hearing in the water is an annoyance, these measures can help minimize exposure to cold water and wind, which are known risk factors. All you have to do is speak to any one who has encountered such problems with their ears, they’ll tell you how important it is and how they wish they looked after their ears early. Let’s face it, know one wants to spend time out of the water.

 

Understanding the prevalence, clinical presentation, and diagnosis of surfer's ear empowers surfers and healthcare providers to identify and address the condition at early stages. Early intervention can help prevent complications and the need for more invasive treatment options.

 

Lastly, the public health implications of surfer's ear cannot be overlooked. Without private health coverage, individuals may face long wait times (3years currently here in WA) in the public health system or substantial financial burdens to address this condition (5-6K per ear). This highlights the importance of prioritising ear care and advocating for accessible healthcare services for all.

 

In conclusion, by embracing preventative measures and seeking timely medical attention, surfers and individuals engaging in water sports can protect their ears from the challenges posed by surfer's ear. Let's celebrate the joy of surfing while also safeguarding our most vital sensory organ – the ears.