External Auditory Canal Exostoses Research Articles

Audiological implications of earplugs used for the prevention of aural exostoses

External auditory canal exostoses may be a preventable disease, so it is surprising that the regular use of water precautions is not greater among surfers. One reason for this is the impairment of hearing whilst wearing earplugs. The objective of this study is to establish the hearing impairment of commonly available earplugs used by surfers. Staff and patients with normal hearing were recruited to have pure tone audiometry performed multiple times, initially with no earplugs, and subsequently with earplugs. Three earplug types were tested which differed in their nature and material (prefabricated elastomer, custom-fitted silicone, and custom-fitted acrylic). Vented and non-vented forms of the earplugs were tested. 30 normal hearing ears were included. Two-tailed paired t-tests comparing hearing thresholds between different earplugs identified that the elastomer earplugs caused the least hearing impairment (p < 0.001). There was no significant difference in hearing thresholds between vented and non-vented elastomer earplugs (p = 0.148), but the difference between vented and non-vented forms of other earplugs was statistically significant (silicone p = 0.010, acrylic p = 0.018). Prefabricated ear plugs produce less hearing impairment than other commonly available earplugs. A customised earplug made of hard material causes the greatest impairment of hearing. We therefore recommend that for aquatic sports where hearing is important, a soft prefabricated earplug is preferable.

Incidence of External Auditory Canal Exostoses in Competitive Surfers in Japan

The objective of this study was to demonstrate the prevalence and severity of external auditory canal exostoses in a population of competitive surfers in Japan. The authors used a “surfing index,” the product of the period (years) as an active surfer and the frequency (number of surfing days per week), to predict external auditory exostoses formation. Cross-sectional study. A total of 5 surfing competitions that were held in Miyazaki, Japan. The ear canals of 373 surfers with an average age of 33.1 years (range, 11-80 years) were examined with an otoscope. The severity of exostosis was classified into 4 groups, ranging from grade 0 to 3, according to otoscopic findings. Subjects also completed a questionnaire detailing their surfing habits. There was a 59.8% overall prevalence of exostoses in 373 surfers. The incidences of grade 1, 2, and 3 exostoses were 118 (31.6%), 71 (19.0%), and 34 (9.1%), respectively. The prevalences of grade 2 and 3 exostoses were higher in surfers with a surfing index of more than 20 (P < .0001). The authors determined that a positive association exists between the surfing index and the severity of exostoses. The findings suggest that it is possible to assume the likelihood of exostosis formation from the surfing index, and this may be of help to spread awareness of exostosis among surfers.

Surfers' awareness of the preventability of ‘surfer's ear’ and use of water precautions

To establish surfers' knowledge of the preventability of external auditory canal exostoses ('surfer's ear'), and their use of water precautions. Survey of surfers conducted between December 2009 and March 2010 at beaches in Cornwall, UK. Ninety-two surfers were included (78 males and 14 females, mean age 27 years, standard deviation 7.9 years). Participants were grouped according to their awareness of the preventability of surfer's ear (55 aware, 37 unaware). These groups were comparable in age, surfing history and gender mix (p > 0.05). Surfers aware of the preventability of exostoses (66 per cent) were more likely to use water precautions than those who were not (38 per cent) (p < 0.01). Two surfers used water precautions regularly and 48 used them occasionally. Sixty-one of the 76 surfers who did not use water precautions (ear plugs) suggested they would consider doing so in the future. Awareness of the preventability of surfer's ear was associated with greater use of water precautions. Further research should explore reasons for the low uptake of such precautions. Most surfers not already using ear plugs would consider doing so in the future.

Audiological implications of earplugs used for the prevention of external auditory canal exostosis

Audiological implications of earplugs used for the prevention of external auditory canal exostosis

External auditory canal exostoses in white water kayakers

ObjectiveIn this study, the presence and severity of external auditory canal exostoses (EACE) in a group of white water kayakers related to the duration and intensity of kayaking and the...

Ossicular Discontinuity and Exostoses in Proteus Syndrome: A Case Report

Proteus syndrome (PS) is a rare hamartomatous disorder characterized by mosaic overgrowth of multiple tissues that manifests early in life and is progressive. The presence of unilateral external auditory canal exostoses in a patient who is not a swimmer or surfer is suggestive of PS. However, hearing loss is not a typical feature. Here, we describe exostoses and ossicular discontinuity with conductive hearing loss in a patient with PS. The treatment consisted of canalplasty and ossicular chain reconstruction. A postoperative reduction was demonstrated in the patient's air-bone gap, from 21 dB to 13 dB for the pure tone average (four frequencies) and from 41 dB to 15 dB in the high-frequency range (6,000 to 8,000 Hz). Causes of ossicular discontinuity are discussed. Routine annual audiometric and otolaryngological evaluation should be considered in all patients with temporal bone involvement of PS.

Imagerie des tumeurs de l'oreille

Tumoural processes of the temporal bone are rare except for vestibular schwannomas of the acoustic-facial bundle and External Auditory Canal (EAC) exostosis. Both CT and MRI should be performed to establish a correct diagnosis and delineate potential trans spatial extension. MRI using pre- and post-contrast T1-weighted sequences, perfusion, SE T2-WI is an excellent method to characterise space occupying lesions such as tumours. MRI delineates better than CT tissular components differentiating vascular processes, tumour with matrix and epidermoid tumours. Unenhanced HRCT depicts excellently osseous lesions such as osteomas, fibrous dysplasias, and chondromas.

Prevalence of external auditory canal exostoses in Australian surfboard riders.

This paper assessed 300 surfboard riders, comprising 229 males and 71 females to determine the prevalence and rate of growth of exostoses in this population. A group of cold water swimmers and a control group were also examined. Significant obstruction, defined as two thirds or more occlusion of the ear canal was noted in 90 of the male surfers and 10 female surfers. This degree of occlusion was found in seven of the 32 cold water swimmers. A male surfer who has surfed regularly for 20 years or more has a one in two chance of developing significant obstruction of the external ear canal resulting from exostoses and this is a three in seven chance for females.

Surgery for External Auditory Canal Exostoses: A Report of 182 Operations

The pre-operative findings and operative outcome were evaluated from patient records in 136 patients (182 ears) who had surgery for external auditory canal (EAC) exostoses. Furthermore, 114 patients (84%) replied to a questionnaire inquiring about the symptoms and the operation’s impact on their quality of life. The main symptoms prior to the surgery were recurrent external otitis, hearing loss and wax retention. Interestingly, 23 patients (21%) were operated without any symptoms. After the operation, 75 patients (66%) had relief of their symptoms. In 33 patients (29%) the symptoms remained the same, and in 5 patients (4%) they became worse. The quality of life improved in 77 patients (68%); 19 patients (14%) had a complication due to the surgery, and 8 patients (6%) needed a re-operation. The surgery for EAC exostoses should be reserved only for symptomatic cases and only for experienced specialists in order to minimize complications and unnecessary operations.

Exostosis of the external auditory canal: a technical note.

To describe the author's method of managing occlusive exostosis of the external auditory canal. Retrospective chart review. Tertiary referral ambulatory otology clinic. A case series of patients treated sequentially by the author over 15 years, all of whom had occlusive external auditory canal exostoses that could not be treated by medical management. Permeatal surgical removal of the anterior exostosis only. Surgical relief of occlusive external auditory canal disease by restoration of hearing and absence of infection with persistence of an external auditory canal and no symptoms of recurrence. A total of 8 men were treated by anterior exostosis removal. Follow-up continued on these patients for a period of 5 to 15 years after the operation, and none showed any evidence of recurrence or tendency to narrowing of the deep ear canal. One patient incurred a tympanic membrane perforation at escostosis surgery that was repaired during the operation. Anterior exostosis removal by a permeatal route is a safe, rapid, and effective method of relieving patients of occlusive external auditory canal exostosis. By leaving the posterior exostosis intact, patients are not put at risk for injury to the facial nerve, chorda tympani nerve, or ossicles. When the deep ear canal is drilled blind, there are no landmarks to indicate the true path of the external canal.

Surgical treatment of auditory canal exostoses

Although complications of surgical removal of external auditory canal exostoses are rare, reported surgical complications include tympanic membrane perforation, postoperative hearing loss, canal stenosis, and facial nerve injuries. We report on our experience in exostosis surgery, consisting of 59 procedures in 48 patients. Preoperative and postoperative complaints and findings, intraoperative complications, and audiologic results are described and discussed. There has been a minimum of one year of follow-up in every case. Postoperative canal stenosis was seen in 2 cases of preoperative severe persistent external otitis. Temporary threshold shift was recorded in 6 patients. Persistent sensorineural hearing loss occurred in 4 patients. Six of the 10 patients with temporary or persistent hearing loss had already shown preoperative sensorineural hearing loss. Intraoperatively tympanic membrane perforation occurred in 3 cases, accidental opening of the mastoid in 1 case. Exostosis surgery should be reserved for uninfected ear canals. Meatal skin preservation without circular meatal flap incision is recommended to avoid postoperative canal stenosis. Especially in cases of preexisting sensorineural hearing loss, attention should be focused on the intraoperative noise reduction by tympanic membrane protection and pauses of noise exposition.

Prevalence of external auditory canal exostoses in surfers.

To determine (1) the prevalence of external auditory exostoses in a population of surfers and (2) the relationship between the length of time spent surfing and the prevalence, severity, and location of the exostoses. Cross-sectional epidemiological study. General community. Three hundred seven avid surfers (93.5% males and 6.5% females; age distributions: 11.2% were < or =20, 67.9% were 21 to 40, 17.5% were 41 to 50, and 3.3% were >50 years). Questionnaires focusing on surfing habits (number of years, geographic region, and number of days per year of surfing) were correlated with otoscopic findings. A simple grading system was devised, based on the degree of external auditory canal stenosis. Grades of normal, mild, moderate, and severe corresponded to 100%, 99% to 66%, 65% to 33%, and less than 33% effective patent surface area, respectively. There was a 73.5% overall prevalence of external auditory exostoses and a 19.2% overall prevalence of osteomas in the group studied. Of 441 ears with exostoses, 54.2% were mild, 23.6% were moderate, and 22.2% were severe. Of individuals who had surfed for 10 years or less, 44.7% had normal ear canals and only 6% had severely obstructed auditory canals. In comparison, in the group that had surfed for longer than 20 years, only 9.1% had normal auditory canals and 16.2% were severely affected. Of surfers with no exostoses, 61.1% had surfed for 10 years or less. In contrast, of surfers with severe exostoses, 82.4% had surfed for more than 10 years. Finally, the lesions seemed to affect all external auditory canal quadrants equally. A positive association exists between the amount of time individuals spend surfing and the presence and severity of exostoses of the external auditory canal.

NONORTHOPAEDIC PROBLEMS IN THE AQUATIC ATHLETE

This article discusses a number of medical conditions that are common to aquatic athletes. Exercise-induced asthma is particularly prevalent in swimmers because swimming is among the activities tolerated best by asthmatics. The healthcare professional frequently must evaluate and manage respiratory infections and infectious mononucleosis in swimmers, particularly in regard to the safe timing of return to training and competition. Dilutional sports pseudoanemia must be differentiated from the true anemias that are due mostly to iron-deficiency and intravascular hemolysis. Finally, the evaluation, management, and prevention of otitis externa, external auditory canal exostoses, and dermatologic disorders in swimmers are reviewed.

A histopathologic review of temporal bone exostoses and osteomata.

It is widely accepted that external auditory canal exostoses and osteomata are separate clinical entities that differ in their gross appearance. Disagreement still exists as to whether external auditory canal exostoses and osteomata should be considered similar or separate histopathologic entities. A chart review was performed of all patients who had external auditory canal exostoses or temporal bone osteomata excised from January 1991 to November 1994 at St. Vincent's Hospital, Sydney. A histologic examination was undertaken with a blind study method of the patients whose pathological specimens were suitable for assessment. Eight exostoses and five osteomata were available for examination. The results of this study demonstrate that exostoses and osteomata of the external auditory canal cannot be reliably differentiated by routine histopathological examination.

Contributions of Chemical Dietary Reconstruction to the Assessment of Adaptation by Ancient Highland Immigrants (Alto Ramirez) to Coastal Conditions at Pisagua, North Chile

At the latitudes of northern Chile the earliest migrants from the highlands were members of the Alto Ramirez cultural group. They arrived in the lower valleys about 1000 BC, where they transferred their highland practices of agriculture and pastoralism to those lower valley sites, acquiring only a minority of their dietary needs from the nearby sea. The unexpected archaeological finding of 11 spontaneously mummified Alto Ramirez bodies at a beach site near Pisagua, northern Chile, provided us an opportunity to evaluate the degree to which they had absorbed and adapted to the subsistence strategy of their purely maritime coastal predecessors (the Chinchorros and their immediate successors, the Quiani people). Using the methodology of chemical dietary reconstruction, supplemented by anatomic observations (external auditory canal exostoses, a "marker" for prolonged cold water exposure-diving; dental analysis), it became clear that this group's subsistence strategy was indistinguishable from that of the coastal maritime populations. This reflects a high degree of coastal adaptation by the highlanders and suggests that they may have been functioning as a subgroup of "marine specialists" for their lower valley kin.

Otolaryngic Osteopathology in 14th Century Mid-America

Over 486 people were massacred and buried communally at the Crow Creek Village Site, South Dakota, about 1350 AD. Osseous pathology in the craniofacial area of the victims' skeletons is reviewed and compared to data from other indigenous skeletal populations past and present. The Crow Creek mastoid x-rays are analyzed and compared to four other studies which span over 1000 years of Dakota Territory history. Findings regarding external auditory canal exostoses in the different groups are compared. Unusual findings in the craniofacial area are assessed. Insight into longitudinal epidemiology in one portion of the U.S. is possible through this study.