Exostoses are benign bony growth of the external auditory canal. They are commonly observed in individuals with frequent water exposure such as surfers or competitive swimmers. These growths are thought to represent a response to a chronic cold-water stimulus.
In the vast majority of cases, exostoses are benign findings during physical examination in patients without any related symptoms. Thus, they are typically incidental findings. However, once the exostoses have narrowed the lumen of the ear canal to much less than 50 percent of its original diameter, affected individuals may become symptomatic. Symptoms include frequent ear wax (cerumen) accumulation, associated hearing loss, and the fact that water will stay trapped behind between the exostoses and the ear drum. This can result in prolonged periods of a plugged ear after each water exposure.
Without any symptoms, exostoses should be watched via annual ENT exams. With symptoms affecting the patient’s quality of life, surgical removal should be contemplated. Removal is more than just a simple office procedure. Specifically, an incision behind the ear is typically required and the bony growths should be drilled rather than chiseled to avoid inadvertent injury to the middle ear. Healing takes about 8 weeks after surgery.