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Cases

Bilateral Exostosis of the External Auditory Canal

Bilateral Exostosis of the External Auditory Canal

An active 36-year-old male presents to the emergency department for a concern unrelated to his ears.  However, his Wispr otoscopic ear exam reveals an interesting finding that points to his past physical activities.

Which of the following is most likely the patient’s favorite pastime?

  1. Triathlons
  2. Mountaineering
  3. Surfing
  4. Sky diving

The patient has bilateral exostosis of the external auditory canal, most likely from cold water exposure due to surfing.

Exostosis is a benign boney growth of the External Auditory Canal (EAC) that occurs secondary to prolonged and repeated exposure to cold water.  Given the hours spent by surfers in the frigid ocean waters, it is not surprising that the condition is found in a high percentage (up to 77%) of competitive surfers.  While our patient was not a competitive surfer himself, he reported frequently traveling the Pacific surf circuit during his years in pursuit of the perfect wave.

Generally, exostosis causes no problems. However, it is possible for the bony growth to become so extensive that hearing is compromised or chronic infections occur. In these cases, surgical intervention is indicated to remove the bony growth.

Here are the video exams from the Wispr otoscope of both ears:

Left Ear Video

Right Ear Video

WiscMed thanks Dr. Greg Rebella of the University of Wisconsin BerbeeWalsh Department of Emergency Medicine for this week’s interesting case.