title: Prevalence of external auditory canal exostoses in surfers.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Cross-sectional epidemiological study.
  
  
  METHODS
  General community.
  
  
  METHODS
  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).
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  A positive association exists between the amount of time individuals spend surfing and the presence and severity of exostoses of the external auditory canal.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery and the Beckman Laser Institute and Medical Clinic, University of California at Irvine, Orange 92868, USA. BJFWONG@BLI.UCI.EDU
authors.forename: B J
authors.initials: BJ
authors.lastname: Wong
authors.forename: W
authors.initials: W
authors.lastname: Cervantes
authors.forename: K J
authors.initials: KJ
authors.lastname: Doyle
authors.forename: A M
authors.initials: AM
authors.lastname: Karamzadeh
authors.forename: P
authors.initials: P
authors.lastname: Boys
authors.forename: G
authors.initials: G
authors.lastname: Brauel
authors.forename: E
authors.initials: E
authors.lastname: Mushtaq
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000209:etiology*; D002140:California; D003080:Cold Temperature / Q000009:adverse effects; D004424:Ear Canal / Q000293:injuries*; D004724:Endoscopy; D005096:Exostoses / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013550:Swimming / Q000293:injuries*