Lifetime prevalence of exostoses in New Zealand surfers

Abstract

INTRODUCTIONExternal auditory exostosis (EAE) is a benign, irreversible bony outgrowth that arises from the temporal bone. EAE projects into the external ear canal, potentially causing recurrent otitis externa and conductive hearing loss. AIMTo determine lifetime prevalence of EAE in New Zealand (NZ) surfers. METHODSThis study used an online national survey. RESULTSRespondents were 1376 NZ surfers (recreational = 868, competitive = 508). Mean surfing experience was 16.2 years. Most self-classified as advanced surfers (36.5%), followed by intermediate (30.2%), expert (20.1%) and beginner (13.2%). Surfers reported an average of 214.2 h surfing (28.6% during winter) for the previous year. Overall lifetime prevalence of EAE was 28.9% (32.1% male, 14.6% female; P < 0.001), with the highest proportion of EAE was observed bilaterally (21.3%). Competitive surfers reported a significantly (P < 0.001) higher lifetime prevalence of EAE than recreational surfers (45.3% vs. 19.2%). A significantly higher (P < 0.001) lifetime prevalence of EAE was identified as skill level increased (7.1% in beginners to 55.6% in experts) and a two-fold increase (P < 0.001) of EAE in the highest (vs. lowest) quartile of surfing exposure. Neither winter surfing exposure nor which Island surfed were associated with EAE prevalence. DISCUSSIONAlthough not as prevalent as in previous NZ research using otologic examinations, this study indicated that almost one-third of NZ surfers reported having had a diagnosis of EAE. Regular general practitioner otologic assessment and advice on appropriate prevention strategies for patients who surf may help prevent large lesions, recurrent ear infections and progressive hearing loss.

The Prevalence and Severity of External Auditory Exostosis in Young to Quadragenarian-Aged Warm-Water Surfers: A Preliminary Study

“…It is interesting to note that when we evaluated exostosis via survey, as opposed to otoscopic examination, we found a lifetime prevalence of only 3.5% in Australian surfers [26] and more recently [30] 28.9% in New Zealand surfers. Chaplin and Stewart [29] reported a lifetime prevalence of exostosis of 73.0% in New Zealand surfers, with one half presenting with a Grade 2 or Grade 3 severity.…”

From the Editor: Aspirations, innovations and reality

“…As a non-surfer, I have always thought that surfers must be exceptionally healthy people so I was surprised and interested to receive a paper about a particular health problem disproportionally affecting surfers (exostoses). 10 I hope readers will find this paper interesting also. Our other clinical paper uses a case-control approach to investigating the usefulness of dermoscopy in general practice surgical procedures.…”

“…The other clinically-oriented papers in this issue relate to pneumococcal disease, 8 mental health, 9 exostoses in surfers, 10 and dermoscope-guided surgical procedures in general practice. 11 Descriptive epidemiology such as the approach presented in the article by Eichler et al 8 is sometimes regarded as rather pedestrian by our public health colleagues but for people working in primary healthcare and delivering vaccines it is both useful and reassuring to have access to this sort of analysis.…”

Surfing on the world stage: a narrative review of acute and overuse injuries and preventative measures for the competitive and recreational surfer

“…Nathanson et al reported lower rates, with EAE and OE representing 7% and 14% of the total number of chronic injuries, respectively 26. More recently, studies in New Zealand and Ireland found EAE in 29% and 66% of surfers, respectively, and also demonstrated that EAE was correlated with increased hours spent surfing 52 53…”