Surfer's ear: exostoses of the external auditory canal.

A 56-year-old white male physician presented with a 5-year history of recurrent and intermittent hearing loss. The symptoms were predominantly right-sided and were increasing in frequency. Hearing loss was interfering with his ability to perform auscultatory examinations. He was able to temporarily restore hearing with the frequent use of carbamide peroxide drops. There was no history of prior ear infections; however, his medical history was significant for prolonged exposure to cold seawater in the form of swimming and body surfing. The exposure occurred over a period of 1215 years. Physical examination demonstrated severe bilateral external auditory canal stenosis . Impacted cerumen was seen occluding the right external auditory canal. There were no signs of infection. Audiologic testing following disimpaction of the cerumen revealed no abnormality. CT was performed in both axial and coronal planes at 1-mm intervals. A multinodular bony mass was seen arising from both the anterior and posterior walls of the right external auditory canal with a residual luminal diameter of 1 mm (Fig. 1 A). Similar findings were demonstrated on the left, although the bony proliferation was smoother and a residual luminal diameter of 2 mm was present (Fig. 1 B). The patient underwent excision of the exostosis in the right ear, creating a 3-4 mm lumen in the external auditory canal (Fig. 1 C). He made an uneventful recovery and has been symptom-free to date.