Dr Colin Brown - Ear, Nose & Throat Surgeon

Surfer's Ear "Exostoses"

Dr Brown is one of the most experienced Exostosis/Surfers Ear surgeons in New Zealand and has excellent and consistent operating results, including protection and maintenance of the hearing. He consults with and operates on patients from all over New Zealand. 

Exostoses are smooth, bony bulges or knobs in the ear canal which are initially symptom free, but progressive growth causes water trapping in the ear which may lead to painful and difficult to treat ear canal infections. They are caused by cold water and air entering the ear canal which is protected by only a very thin layer of skin over the bone which grows with cumulative exposure to the cold.  As this is a progressive condition, the time until symptoms develop depends on cumulative time spent swimming, surfing, windsurfing, water skiing and kite surfing. Typically, this affects men in their 30s onwards and because of our long coastline and relatively cool water, is very common in New Zealand. People may present with difficulty clearing water from the ear, often having to resort to shaking the head or hopping. Water trapping predisposes to ear canal infections which may be very slow to settle as the ear canal is narrowed further by inflammation in the canal skin, making it even more difficult to clear infected debris. Usually temporary hearing loss and/or ringing in the ears may result until the infection settles. In the non-infected state, one may see multiple smooth, pale prominences in the canal.

Treatment is generally by prevention. This involves using ear plugs for all cold water sports. “Blue tac” works well, but "Surf Ears" ( bought online) or “Doc’s Pro Plugs” (available from audiology clinics) generally allow one to hear better while wearing them. Audiologists can also custom make ear plugs.  Neoprene hoods or “ear wraps” (also available from audiology clinics) are also both protective and may prevent loss of ear plugs. Alcohol ear drops are good to use after water exposure. These help displace moisture and evaporate quickly, leaving a slightly acidic protective residue. A good alternative, if you are travelling and forget to take alcohol drops with you, is vodka or gin!

Otitis externa is treated with antibiotic steroid drops, and may also require the ear/s to be suctioned free of debris. Generally “Sofradex” antibiotic drops are a good first line, but if the bacterium pseudomonas is suspected (because of its green tinged discharge, odour, history of recent swimming pool use or because of a swab result) Ciproxin HC drops or ciloxan would be a good choice.

When is surgery needed?

Surgical treatment is necessary when the exostoses are symptomatic with water trapping or ear infections are not easily manageable with ear drops and or ear plugs. If the exostoses are large and if on-going cold water exposure is anticipated, surgical treatment may also be recommended. Many surfers don’t like wearing ear plugs and  should have large exostoses removed before too many problems begin. 

Surgery is a safe and effective treatment for exostoses and involves elevating the ear canal skin off the exostoses and then drilling them away. The skin is then replaced and held in place with a dressing while it heals. Operations are performed on a day stay basis and are tailored to the individual. We can do minimally invasive "chisel" removal down through the ear canal for moderate size exostoses, and for severe exostoses a discrete cosmetic incision is made tucked into the crease behind the ear and a combination of chisel and micro drill is used.  Discomfort is mild afterwards, and the ear needs to be protected from water from 4-12 weeks ( depending on the procedure best suited).  After exostosis surgery,  all should use ear protection from the cold to minimise the risk of the exostoses re growing.

Dr Brown can do telehealth/video consultations for you if you live away from Auckland and have good quality photos of your ear canals taken by an audiologist or your GP, and a diagnostic hearing test.

Consultations and surgery are usually both covered by health insurance.

For more information Click here 

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