Exostoses of the external auditory canal: a long-term follow-up study of surgical treatment

Abstract

To determine the postoperative incidence, extent and recurrence rate of exostoses of the external auditory canal in a cohort of patients involved in different water sports. A cross-sectional study of 31 patients (46 ears), with exostoses treated by surgery in the Royal Cornwall Hospital between 1980 and 1999. A questionnaire was used to obtain information about the type of water exposure pre- and postoperatively. The extent of recurrent stenosis was assessed. The mean postoperative time interval was 10 years (sd = 4.5 years). The degree of stenosis was assessed as: minimal (<30%) in 42.6%, moderate (30-60%) in 31% and severe (>60%) in 25% of ears. The Cox regression model was used to identify factors associated with a reduction in the recurrence rate of stenosis. The use of ear plugs was highly significant (P = 0.015), as was the age of the patient at the time of operation (P = 0.004), i.e. the older the patient, the faster recurrent disease developed. There was no evidence to show that either the type or seasonal pattern of water sport activity influenced recurrence of the disease postoperatively, although preoperatively, the stenosis was more marked in association with surfing and sailing. Exostoses developed faster preoperatively in those who were in the water all year round rather than just the summer months. Of five patients who stopped water sport activity completely after surgery, four of them developed significant recurrent exostoses (>50% stenosis).

Auditory exostoses among the prepottery neolithic inhabitants of Çayönü and Aşıklı, Anatolia; its relation to aquatic activities

“…Clinical results, along with research carried out on living and archeological samples, suggest that multiple temperature stressors may place individuals at risk for auditory exostoses (King et al, 2010;Deleyiannis et al, 1996;Hutchinson et al, 1997;Katayama, 1998;Fabiani et al, 1984;Timofeev et al, 2004;Kennedy, 1986;Okumura et al, 2007;Sheard and Doherty, 2008). Katayama (1998), for example, proposed a "thermal aquatic hypothesis".…”

“…Hutchinson et al (1997) indicate that the initial trigger for ear exostoses is most commonly otitis externa, and they add that the environmental conditions that cause otitis externa are exposure to excessive cold, heat or water. Timofeev et al (2004) added that otitis externa associated with water was thought to develop auditory exostoses. Consequently, the fact that pathology of the external ear is due to otitis externa is largely accepted (Hutchinson et al, 1997).…”

“…Exostoses are more frequently observed among people who live on coastal regions and have a habit of fishing for marine resources by diving into deep cold water (Van Gilse, 1938;Hutchinson et al, 1997;Kroon et al, 2002;Timofeev et al, 2004;Sheard and Doherty, 2008). Dastugue and Gervais (1992) define oral exostoses as an 'occupation illness'.…”

A Stress or Migration Marker (A Study of the Auditory Canal Exostosis in the Skeleton Material of the Middle Bronze Age Population From the Lower Volga Region Burial Grounds)

“…М. Окамура и К. Годде предполагают, что ушные экзостозы у популяций в центральной части материков развиваются в результате пере-охлаждения под влиянием низкой температуры воздуха или холодного ветра [Godde, 2010, p. 489;Okumura, 2007, p. 564]. Схожую точку зрения находили и у ряда современных отоларин-гологов Timofeev et al, 2004;.…”

Audiological implications of earplugs used for the prevention of aural exostoses

“…This patient had a myringoplasty (for a surfinginduced tympanic membrane perforation) in the right ear 10 years earlier and had continued to wear an earplug in that ear subsequently when surfing, but not in the left [6]. Timofeev et aldemonstrated a statistically significant reduction in the recurrence rate of exostoses following primary exostoses removal surgery in those using earplugs regularly [7].…”