Surfer’s ear is caused by repeated exposure to cold water and wind. This is because the skin of the inner ear canal is paper thin and there is no insulating layer between this layer and a deeper layer that stimulates new bone growth.



Surfer's Ear is formally known as exostoses.

The ear canal consists of a cartilaginous part and a bony part. 

The bony prominence which occurs at the bony part of the external ear canal is known as exostoses.



This picture shows the normal appearance of an ear drum.

We can see the transparent ear drum and an ossicle called the hammer.

There are many variations in the shape of surfer’s ear.

The shapes of the bony prominence are quite different in each case. At the beginning, usually the bony prominence is formed at the superior part of the external ear canal. However, even in the mild cases of surfer’s ear there is a lot of variety of shapes.





In the  early stages there are seldomly any symptoms.

Difficulty to drain water is a common symptom of surfer's ear. Based on my epidemiological study, usually this symptom gets worse when the ear canal has narrowed to about 50% obstruction.Tinnitus and itching of the ear may also occur.

And in severe cases, hearing loss or repetitive inflammation accompanied with earache may occur.

Hearing loss is not an accompanying symptom even in severe cases unless it is associated with acute inflamation of the external ear canal. 


This picture shows the typical results of a CT scan of the external ear canal.

Rt.normal case.

Lt.Surfer's Ear (Exosotoses) case.


In some cases, the ear drum and mastoid air cells are very close to the bony prominence. 

If a surgeon cuts here without care, perforation of the ear drum or mastoid air cell opening can occur , and lead to infectious complications after surgery

Before the operation, we use surgical position reconstruction images by CT scan as it enables us to estimate how much bony lesion can be safely removed. 

The thickness of surfer's ear lesion is not even.