Abstract
PurposeCold water and wind are known to cause exostoses of the external auditory canal. Different prevalences in different sports have been described in the literature. The aim of this study was to investigate the prevalence of external auditory exostosis (EAE) and EAE severity in coastal German wind- and kitesurfers who are exposed to cold water and strong winds. Furthermore, influencing factors such as the total exposure time and frequency of activity as well as the correlations between symptoms and the severity of EAE were investigated.MethodsIn this retrospective cross-sectional study, German non-professional wind- and kitesurfers along the North and Baltic Sea coasts were recruited between September 2020 and November 2020. Each participant was interviewed about exposure time and otological symptoms and underwent bilateral video otoscopic examination to determine EAE severity.ResultsA total of 241 ears from 130 subjects were analysed. The prevalence of EAE was 75.1%. In 19.9% of the participants, severe EAE was found. Exposure time and the frequency of activity had significant effects on the severity of EAE. Compared to surfers, EAE growth seems to progress faster in wind- and kitesurfers. The number of symptoms requiring medical treatment increased when two-thirds of the external auditory canal was obstructed.ConclusionThe prevalence of EAE in wind- and kitesurfers is high. Total exposure time and the frequency of activity influence EAE growth. EAE growth occurs faster in wind- and kitesurfers than in surfers. The additional influence of wind and the evaporative cooling of the EAC are thought to be responsible. The results of this study should increase awareness of the dynamics of EAE among ENT specialists and improve patient counselling.
Highlights
External auditory exostoses (EAE) are benign, usually bilateral and symmetrical bony growths with a broadbased origin at the tympanic ring of the external auditory canal (EAC)
The pathogenesis of EAE has not yet been conclusively explained, studies clearly indicate a relationship with frequent exposure of the EAC to water
The aim of this study was to investigate (i) the prevalence of EAE, (ii) the severity of EAC obstruction and (iii) the associated symptoms in coastal German wind- and kitesurfers who are exposed to cold water and strong winds (≈ > 4 Beaufort)
Summary
External auditory exostoses (EAE) are benign, usually bilateral and symmetrical bony growths with a broadbased origin at the tympanic ring of the external auditory canal (EAC). These irreversible lesions are characterized by laminar layers of subperiosteal bone [1, 2]. Due to the high prevalence of EAE in surfers, the term “Surfer’s Ear” was introduced by Seftel in 1977 [3]. The degree of obstruction that results in clinically significant symptoms or requires medical treatment is not clearly understood [7, 14, 15].
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