Purpose: The objectives of this study were to determine the cold water exposure necessary to produce exostoses of the external auditory canal in individuals who predominantly surf along the Oregon and/or the northern California coastline and to ascertain from surfers' otologic histories symptoms attributable to exostoses.
Materials and methods: Free ear examinations were provided at two surf shops in northern Oregon. The ear canals were examined with an otoscope, and each surfer was given a summary score indicating the percentage of both canals that was obstructed by exostoses. Surfers were then categorized according to the number of years surfing and the number of sessions surfing per year.
Results: Twenty-one surfers met our criteria for analysis. The degree of ear canal obstruction significantly increased with increasing number of years surfing (P < .001) and with increasing number of sessions surfing per year (P < .01). The median summary scores were 7.5, 63.0, and 93.0 for individuals who respectively surfed between 1 and 5 years, between 6 and 15 years, and greater than 15 years. The median summary scores were 10.0 for individuals who surfed 50 sessions or less per year versus 87.5 for individuals who surfed greater than 50 sessions per year. Most surfers with exostoses had minimal complaints. Only one patient had a history of surgical treatment.
Conclusion: Individuals who surf 5 years or less are unlikely to develop exostoses unless they are surfing greater than 50 sessions per year. Exostoses are typically a benign malady that do not require surgical therapy.