External auditory canal exostosis

January 24, 2013 by Joseph A. Ursick, MD; Jose N. Fayad, MD
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Otoscopic Clinic

Exostoses, composed of immature layers of lamellar bone that cause a progressive stenosis of the external ear canal, are typically bilateral, occur at suture lines, and are associated with repeated exposure to cold water.

 A 62-year-old male surfer presented with a gradual bilateral hearing loss, worse on the right side. On otoscopy, his external auditory canals were occluded by multiple bony outgrowths (figure). Audiometry revealed a right-sided conductive hearing loss with normal bone conduction thresholds. The patient underwent surgery on his right, poorer-hearing ear. Through a postauricular approach, the exostoses were removed with a high-speed drill and diamond burs.

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