Skip to main content

The effects of surfing behaviour on the development of external auditory canal exostosis

European Archives of Oto-Rhino-Laryngology volume 272, pages 1643–1649 (2015)Cite this article

Abstract

To examine how individual surfing behaviour affects the development of external auditory canal exostosis and to produce a model to predict exostosis severity. A standardised questionnaire was completed and each participant underwent an otoscopic examination. Surfers were recruited from August to October 2011 from surfing competitions and from colleges in the South West of England. 207 surfers were included, 53 % had evidence of external auditory canal; exostosis: grade 1, 23 %; grade 2, 16 %, grade 3, 16 %. This risk of exostosis significantly increased with (1) surfing for 6 or more years, (2) surfing in the winter months, (3) surfing five or more times per month in the winter and (4) reported ear symptoms. Interestingly, participation in other water sports and wearing earplugs or a hood reduced the risk of developing exostosis. Surfers who surf in England are at significant risk of exostosis. A probability model was designed, incorporating different surfing behaviours and ear symptoms, the first of its kind in exostosis research. This model will be a useful tool for raising awareness of external ear canal exostosis in the surfing community and in assessing individual need for surgical intervention.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3

References

  1. Crowe F, Sperduti A, O’Connell TC et al (2010) Water-related occupations and diet in two Roman coastal communities (Italy, first to third century AD): correlation between stable carbon and nitrogen isotope values and auricular exostosis prevalence. Am J Phys Anthropol 142(3):355–366

    Article  PubMed  Google Scholar 

  2. Okumura MM, Boyadjian CH, Eggers S (2007) Auditory exostoses as an aquatic activity marker: a comparison of coastal and inland skeletal remains from tropical and subtropical regions of Brazil. Am J Phys Anthropol 132(4):558–567

    Article  PubMed  Google Scholar 

  3. Skoulakis C, Papadakis C, Stavroulaki P, Drivas E, Valagiannis D (2008) The otologic problem and death of Heinrich Schliemann. Eur Arch Otorhinolaryngol 265(5):575–580

    Article  PubMed  Google Scholar 

  4. Kroon DF, Lawson ML, Derkay CS, Hoffmann K, McCook J (2002) Surfer’s ear: external auditory exostoses are more prevalent in cold water surfers. Otolaryngol Head Neck Surg 126(5):499–504

    Article  PubMed  Google Scholar 

  5. Sheard PW, Doherty M (2008) Prevalence and severity of external auditory exostoses in breath-hold divers. J Laryngol Otol 122(11):1162–1167

    Article  CAS  PubMed  Google Scholar 

  6. Cooper A, Tong R, Neil R, Owens D, Tomkinson A (2010) External auditory canal exostoses in white water kayakers. Br J Sports Med 44(2):144–147

    Article  CAS  PubMed  Google Scholar 

  7. Kenndey GE (1986) The relationship between auditory exostoses and cold water: a latitudinal analysis. Am J Phys Anthropol 71(4):401–415

    Article  Google Scholar 

  8. Umeda Y, Nakajima M, Yoshioka H (1989) Surfer’s ear in Japan. Laryngoscope 99(6 Pt 1):639–641

    CAS  PubMed  Google Scholar 

  9. Wong BJ, Cervantes W, Doyle KJ, Karamzadeh AM, Boys P et al (1999) Prevalence of external auditory canal exostoses in surfers. Arch Otolaryngol Head Neck Surg 125(9):969–972

    Article  CAS  PubMed  Google Scholar 

  10. Hurst W, Bailey M, Hurst B (2004) Prevalence of external auditory canal exostoses in Australian surfboard riders. J Laryngol Otol 118(5):348–351

    Article  PubMed  Google Scholar 

  11. King JF, Kinney AC, Iacobellis SF 2nd et al (2010) Laterality of exostosis in surfers due to evaporative cooling effect. Otol Neurotol 31(2):345–351

    Article  PubMed  Google Scholar 

  12. Karegeannes JC (1995) Incidence of bony outgrowths of the external ear canal in U.S. Navy divers. Undersea Hyperb Med 22(3):301–306

    CAS  PubMed  Google Scholar 

  13. Moore RD, Schuman TA, Scott TA, Mann SE, Davidson MA et al (2010) Exostoses of the external auditory canal in white-water kayakers. Laryngoscope 120(3):582–590

    Article  PubMed  Google Scholar 

  14. Chaplin JM, Stewart IA (1998) The prevalence of exostoses in the external auditory meatus of surfers. Clin Otolaryngol Allied Sci 23(4):326–330

    Article  CAS  PubMed  Google Scholar 

  15. AFP (2004) Surfing rides––new waves of popularity. From http://www.ukinindia.com/magazines/britaintoday/BTInnerpage.asp?Issuesld=77&magzineld=3&Sectionld=555. Retrieved 22nd May 2007

  16. Alexander (2007) Surf safety. From http://www.bbc.co.uk/weather/sports/features/surf_safety.shtml. Retrieved 22nd May, 2007

  17. SurfScience (2013) Surf lingo, category G and R. From http://www.surfscience.com/surf-lingo/. Retrieved 15th June

  18. Hutt J, Black K, Mead S (2001) Classification of surf breaks in relation to surfing skill. J Coastal Res 29:66–81

    Google Scholar 

  19. The Met Office 1854. South West England: climate. From http://www.metoffice.gov.uk/climate/uk/sw/. Retrieved 15th June

  20. Magic Seaweed LTD. Cornwall & Devon South Surfing. From http://magicseaweed.com/Cornwall-%26-Devon-South-Surfing/5/. Retrieved 15th June 2011

  21. Hempel J, Foreell S, Krause E, Muller J, Brun T (2011) Surgery for outer ear canal exostoses and osteomata: focusing on patient benefit and health-related quality of life. Otol Neurol 33(1):83–86

    Article  Google Scholar 

  22. Whitaker L, Cordier A, Kosjakov S, Charbonneau R (1998) Treatment of external auditory canal exostoses. Laryngoscope 108(2):195–199

    Article  CAS  PubMed  Google Scholar 

  23. Timofeev I, Notkina N, Smith IM (2004) Exostoses of the external auditory canal: a long-term follow-up study of surgical treatment. Clin Otolaryngol Allied Sci 29(6):588–594

    Article  PubMed  Google Scholar 

  24. Reddy VM, Abdelrahman T, Lau A, Flanagan PM (2011) Surfers’ awareness of the preventability of ‘surfer’s ear’ and use of water precautions. J Laryngol Otol 125(6):551–553

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Andrew Bailey, University of Plymouth, Centre for Health and Environmental Statistics, Research Assistant is acknowledged for aiding with the completion of the statistical analysis.

Conflict of interest

This study was not sponsored by any individual or group. There are no conflicts of interest.

Author information

Authors and Affiliations

  1. Plymouth Hospitals NHS Trust, 19 Alton Road, Croydon, Surrey, CR0 4LZ, UK

    V. Alexander

  2. Plymouth Hospitals NHS Trust, Derriford Road Crownhill, Plymouth, Devon, PL6 8DH, UK

    A. Lau & A. Hope

  3. University of Plymouth, A519, Portland Square Drake Circus, Plymouth, Devon, PL4 8AA, UK

    E. Beaumont

Authors
  1. V. Alexander
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Lau
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Beaumont
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Hope
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to V. Alexander.

Additional information

Work completed by institution: Ear, Nose and Throat Department in conjunction with the University of Plymouth.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Alexander, V., Lau, A., Beaumont, E. et al. The effects of surfing behaviour on the development of external auditory canal exostosis. Eur Arch Otorhinolaryngol 272, 1643–1649 (2015). https://doi.org/10.1007/s00405-014-2950-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-014-2950-5

Keywords

  • Ear disease
  • Surfers ear
  • Exostosis
  • Exostoses
  • Adult
  • Young adult
  • Water
  • Surfing
  • Ear protection