1
|
Leclère JC, Cerceau L, Mornet E, Marianowski R. External ear canal exostectomy: influence of surgeon's experience on 3-years recurrence and occurrence of complications. EAR, NOSE & THROAT JOURNAL 2024; 103:351-356. [PMID: 34791926 DOI: 10.1177/01455613211056555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND External ear canal exostoses are usually bilateral and broad-based, secondary to external ear canal chronic cold exposure, especially water. OBJECTIVES The objectives were to analyze the influence of the surgeon's experience on the 3-year recurrence and on the complication. We also studied the influence of prolonged exposure to cold water on the incidence of recurrence. MATERIAL AND METHODS This monocentric retrospective study included 98 ears operated for canalplasty between 2009 and 2016 by nine different operators including one senior, a junior, and seven beginner surgeons. Senior, Junior, and Beginner groups were compared. RESULTS 3-year recurrence rate was higher in the Beginner and Junior groups than in the Senior group (69% and 38% vs 18%, P = .001). Although there was a difference between the Beginner (69%) and Junior (38%) groups, it was not significant (P = .407). Among the recurrences, 48% had continued exposure to cold water while only 7% of the ears without recidivism were still exposed (P < .001, OR = 1.25 [4.4; 36.1]). The complication rates were similar between groups, concerning pain (8% vs 30% vs 12%), per procedure perforation (17% vs 10% vs 16%), scarring disorders (25% vs 20% vs 13%), and osteitis (8% vs 0% vs 1%). Hearing was unaffected. CONCLUSIONS This is the first study evaluating the risk of recurrence of external ear canal exostoses after canalplasty based on the surgeon's experience. This risk of recurrence seems to decrease with the surgeon's experience. There was no difference in complication rates.
Collapse
Affiliation(s)
| | - Laura Cerceau
- Department of Head and Neck Surgery, Brest University Hospital, Brest, France
| | - Emmanuel Mornet
- Department of Head and Neck Surgery, Brest University Hospital, Brest, France
| | - Rémi Marianowski
- Department of Head and Neck Surgery, Brest University Hospital, Brest, France
| |
Collapse
|
2
|
Sánchez Varela N, Vidal Gómez M, Portela Romero M. [External auditory canal exostosis or surfer's ear]. Semergen 2024; 50:102131. [PMID: 38154370 DOI: 10.1016/j.semerg.2023.102131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 10/10/2023] [Indexed: 12/30/2023]
Affiliation(s)
- N Sánchez Varela
- Medicina Familiar y Comunitaria, Centro de Salud Concepción Arenal, Santiago de Compostela, Galicia, España.
| | - M Vidal Gómez
- Medicina Familiar y Comunitaria, Centro de Salud Concepción Arenal, Santiago de Compostela, Galicia, España
| | - M Portela Romero
- Medicina Familiar y Comunitaria, Centro de Salud Concepción Arenal, Santiago de Compostela, Galicia, España
| |
Collapse
|
3
|
Vallée A. External auditory exostosis among surfers: a comprehensive and systematic review. Eur Arch Otorhinolaryngol 2024; 281:573-578. [PMID: 37777626 DOI: 10.1007/s00405-023-08258-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/19/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVE External auditive exostosis (EAE), known as surfer's ear, is a temporal bone outgrowth resulting from ear exposure to cold air and water. This review aims to shed light on the prevalence of EAE among worldwide surfers. METHODS By a thorough retrieval of the PubMed, we found all original investigations performed on EAE among suffers. The retrieval time was from the construction of the database to December 2022. Agency for Healthcare Research and Quality (AHRQ) methodology checklist for assessing the quality of cross-sectional/prevalence study was performed. RESULTS 19 articles were selected involving 2997 surfers on whom 2032 presented EAE. The prevalence of EAE was ranged from 53 to 90% with a mean at 67.8%. 3 investigations were performed from USA, five from UK and Ireland, five from Australia and New Zealand and six from Japan and Europe. CONCLUSION Cold water exposure, combined with wind and prolonged surfing activity, contributes to the development of EAE. Symptoms range from mild discomfort to hearing loss and recurrent infections. Preventive measures, such as raising awareness and promoting the use of ear protection, are crucial. Further research is needed to improve prevention strategies and understand the underlying mechanisms of EAE.
Collapse
Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology and Public Health, Foch Hospital, Suresnes, France.
| |
Collapse
|
4
|
Wegener F, Wegner M, Weiss NM. What do windsurfers and kitesurfers in Germany know about surfer's ear and how is it influenced by protective measures? J Laryngol Otol 2024; 138:52-59. [PMID: 37016896 PMCID: PMC10772022 DOI: 10.1017/s0022215123000610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/13/2023] [Accepted: 03/23/2023] [Indexed: 04/06/2023]
Abstract
OBJECTIVE This study investigated the frequency of ear canal protection use and looked at its influence on external auditory exostosis severity and knowledge about external auditory exostosis among windsurfers and kitesurfers on the German coast. METHOD This retrospective cross-sectional study interviewed 130 windsurfers and kitesurfers along the German coast on knowledge of external auditory exostosis, exposure time, use of neoprene hoods and earplugs, and otological complaints. Participants underwent bilateral video-otoscopic examination. RESULTS Knowledge of external auditory exostosis was 'good' or 'excellent' in 78 of 130 (60 per cent) individuals and 'poor' or non-existent in 52 of 130 (40 per cent) individuals. Knowledge was positively correlated with hours of exposure, otological complaints and frequency of ear canal protection use. A significant negative influence of neoprene hood use on external auditory exostosis severity was shown. CONCLUSION The positive effect of external auditory exostosis knowledge on the frequency of ear canal protection and the reduction of external auditory exostosis risk implies a need for health education on this topic.
Collapse
Affiliation(s)
- F Wegener
- Institute of Sport Science, Christian-Albrechts University, Kiel, Germany
| | - M Wegner
- Institute of Sport Science, Christian-Albrechts University, Kiel, Germany
| | - N M Weiss
- Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr University Bochum, St Elisabeth Hospital, Bochum, Germany
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Antwerp University, Antwerp, Belgium
- International Graduate School of Neuroscience, Ruhr University Bochum, Bochum, Germany
| |
Collapse
|
5
|
Kloth C, Beck A, Sollmann N, Beer M, Horger M, Thaiss WM. Imaging of Pathologies of the Temporal Bone and Middle Ear: Inflammatory Diseases, Their Mimics and Potential Complications-Pictorial Review. Tomography 2023; 9:2190-2210. [PMID: 38133074 PMCID: PMC10747582 DOI: 10.3390/tomography9060170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
Imaging of the temporal bone and middle ear is challenging for radiologists due to the abundance of distinct anatomical structures and the plethora of possible pathologies. The basis for a precise diagnosis is knowledge of the underlying anatomy as well as the clinical presentation and the individual patient's otological status. In this article, we aimed to summarize the most common inflammatory lesions of the temporal bone and middle ear, describe their specific imaging characteristics, and highlight their differential diagnoses. First, we introduce anatomical and imaging fundamentals. Additionally, a point-to-point comparison of the radiological and histological features of the wide spectrum of inflammatory diseases of the temporal bone and middle ear in context with a review of the current literature and current trends is given.
Collapse
Affiliation(s)
- Christopher Kloth
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany; (N.S.); (M.B.); (W.M.T.)
- Radiology and Radiation Therapy Lindau, Friedrichshafener Str. 83, 88131 Lindau (Lake Constance), Germany
| | - Annika Beck
- Institute of Pathology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany;
| | - Nico Sollmann
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany; (N.S.); (M.B.); (W.M.T.)
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
- TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany; (N.S.); (M.B.); (W.M.T.)
| | - Marius Horger
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany;
| | - Wolfgang Maximilian Thaiss
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany; (N.S.); (M.B.); (W.M.T.)
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany;
- Department of Nuclear Medicine, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| |
Collapse
|
6
|
Swisher AR, Singh P, Debbaneh P, Rivero A. Complication Rates in Osteotome and Drill Techniques in External Auditory Canal Exostoses: A Systematic Review and Meta-Analysis. Ann Otol Rhinol Laryngol 2023; 132:1249-1260. [PMID: 36635864 DOI: 10.1177/00034894221147804] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To assess and compare complication rates of symptomatic external auditory canal (EAC) exostoses treated with drill versus osteotome canalplasty. DATABASES REVIEWED PubMed/Medline, OVID, EMBASE, Web of Science, Google Scholar. METHODS A systematic review and meta-analysis in accordance with PRISMA guidelines and standardized bias assessment using the JBI critical appraisal checklist was performed. Studies containing original outcome data on drill and osteotome canalplasty were included. The primary study outcome was complication rates. RESULTS Fifteen studies were included, encompassing 1399 total patients (1788 ears) with 530 and 1258 ears in the osteotome and drill groups, respectively. Ten studies used a drill, 2 used an osteotome, and 3 used both. The most frequently reported complications were tympanic membrane (TM) perforation (osteotome group: 5.3% [95% CI: 1.7%-10.9%]; drill group: 3.8% [1.5%-7.1%]), sensorineural hearing loss (SNHL) (0.69% [0.07%-1.9%]; 4.3% [2.2%-7.0%]), and postoperative stenosis (1.1% [0.0005%-4.3%]; 4.1% [1.9%-7.0%]). Use of the osteotome was associated with a lower rate of SNHL (P < .05) and stenosis (P < .05), and a higher rate of TM perforation (P < .05). Heterogeneity of the studies included in the analyzed complications ranged from moderate to high. Level of evidence in the included studies ranged from 2b to 4 and all studies had an overall low risk of bias. CONCLUSION While an osteotome technique may increase the risk of TM perforation, drill canaloplasty may increase the risk of SNHL and postoperative stenosis in EAC exostectomy. The exact quantity of hearing loss could not be definitively evaluated. Additional research with participant randomization is needed to assess clinical efficacy. LEVEL OF EVIDENCE Level 8.
Collapse
Affiliation(s)
- Austin R Swisher
- Riverside School of Medicine, University of California, Riverside, CA, USA
| | - Priyanka Singh
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Peter Debbaneh
- Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente, Oakland, CA, USA
| | - Alexander Rivero
- Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente, Oakland, CA, USA
| |
Collapse
|
7
|
An awareness and prevalence study of Irish cold-water athletes and external auditory canal exostoses. The Journal of Laryngology & Otology 2022; 136:659-667. [DOI: 10.1017/s0022215121004369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveThis study aimed to determine the awareness, otological symptoms and prevalence of external auditory canal exostoses in Irish cold-water athletes.MethodAn online and in person cross-sectional survey was undertaken with Irish cold-water athletes to explore athletes' awareness, known prevalence of external auditory canal exostoses and attitudes towards preventive measures.ResultsOf the 926 participants surveyed, 67.5 per cent were aware of external auditory canal exostoses. Triathletes reported the lowest awareness (39.9 per cent) among water athletes. A total of 9.7 per cent (n = 90) had previously been diagnosed with external auditory canal exostoses and 46.7 per cent (n = 42) were non-surfers. Ear symptoms were reported in 76 per cent of athletes. Otoscopic examinations showed that 23.7 per cent had external auditory canal exostoses, 3.6 per cent of whom were aware of their diagnosis.ConclusionThe majority of Irish surfing athletes are aware of external auditory canal exostoses. There is less awareness with regard to Ireland's newly emerging sports such as open water swimming and triathlons. Over 90 per cent of athletes surveyed had no idea they had external auditory canal exostoses, which highlights the need to increase public awareness.
Collapse
|
8
|
Wegener F, Wegner M, Weiss NM. External auditory exostoses in wind-dependent water sports participants: German wind- and kitesurfers. Eur Arch Otorhinolaryngol 2021; 279:2353-2361. [PMID: 34146149 PMCID: PMC8986730 DOI: 10.1007/s00405-021-06939-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/09/2021] [Indexed: 11/13/2022]
Abstract
Purpose Cold water and wind are known to cause exostoses of the external auditory canal. Different prevalences in different sports have been described in the literature. The aim of this study was to investigate the prevalence of external auditory exostosis (EAE) and EAE severity in coastal German wind- and kitesurfers who are exposed to cold water and strong winds. Furthermore, influencing factors such as the total exposure time and frequency of activity as well as the correlations between symptoms and the severity of EAE were investigated. Methods In this retrospective cross-sectional study, German non-professional wind- and kitesurfers along the North and Baltic Sea coasts were recruited between September 2020 and November 2020. Each participant was interviewed about exposure time and otological symptoms and underwent bilateral video otoscopic examination to determine EAE severity. Results A total of 241 ears from 130 subjects were analysed. The prevalence of EAE was 75.1%. In 19.9% of the participants, severe EAE was found. Exposure time and the frequency of activity had significant effects on the severity of EAE. Compared to surfers, EAE growth seems to progress faster in wind- and kitesurfers. The number of symptoms requiring medical treatment increased when two-thirds of the external auditory canal was obstructed. Conclusion The prevalence of EAE in wind- and kitesurfers is high. Total exposure time and the frequency of activity influence EAE growth. EAE growth occurs faster in wind- and kitesurfers than in surfers. The additional influence of wind and the evaporative cooling of the EAC are thought to be responsible. The results of this study should increase awareness of the dynamics of EAE among ENT specialists and improve patient counselling.
Collapse
Affiliation(s)
- Florian Wegener
- Institute of Sport Science, Christian-Albrechts-University Kiel, Olshausenstraße 74, 24098, Kiel, Germany.
| | - Manfred Wegner
- Institute of Sport Science, Christian-Albrechts-University Kiel, Olshausenstraße 74, 24098, Kiel, Germany
| | - Nora M Weiss
- Department of Otorhinolaryngology, Head and Neck Surgery "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany
| |
Collapse
|
9
|
Climstein M, Simas V, DeBeliso M, Walsh J. A novel method for the determination of exostosis severity in the external auditory canal. Clin Otolaryngol 2021; 46:1247-1250. [PMID: 34142441 DOI: 10.1111/coa.13824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 05/04/2021] [Accepted: 06/13/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Mike Climstein
- Aquatic Based Research Unit, Faculty of Health, Southern Cross University, Bilinga, QLD, Australia.,Water Based Research Unit - Bond Institute of Health and Sport, Bond University, Gold Coast, QLD, Australia.,Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, University of Sydney, Sydney, NSW, Australia
| | - Vini Simas
- Water Based Research Unit - Bond Institute of Health and Sport, Bond University, Gold Coast, QLD, Australia
| | - Mark DeBeliso
- College of Health Sciences, Southern Utah University, Cedar City, UT, USA
| | - Joe Walsh
- Sports Science Institute, Sydney, NSW, Australia
| |
Collapse
|
10
|
Simas V, Hing W, Rathbone E, Pope R, Climstein M. Auditory exostosis in Australian warm water surfers: a cross-sectional study. BMC Sports Sci Med Rehabil 2021; 13:52. [PMID: 33990216 PMCID: PMC8122542 DOI: 10.1186/s13102-021-00281-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/06/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Surfing is a popular sport in Australia, accounting for nearly 10% of the population. External auditory exostosis (EAE), also referred to as surfer's ear, is recognized as a potentially serious complication of surfing. Cold water (water temperature below 19 °C) is a commonly cited risk factor, with prevalence of EAE in cold water surfers ranging from 61 to 80%. However, there is a paucity of studies reporting the prevalence of EAE in surfers exposed to water temperatures above 19 °C. With mean water temperature ranging from 19 °C to 28 °C, the Gold Coast region of Australia provides the ideal environment to assess the main goal of this study: to assess the prevalence and severity of EAE in warm water surfers. METHODS Eligible participants were surfers living and surfing on the Gold Coast (Queensland, Australia). Currently active surfers over 18 years of age, surfing year-round, with a minimum of five consecutive years of surfing experience were recruited to participate. Included individuals were asked to complete a questionnaire and underwent bilateral otoscopy. RESULTS A total of 85 surfers were included, with mean age 52.1 years (standard deviation [SD] ±12.6 years) and mean surfing experience of 35.5 years (SD ±14.7 years). Nearly two-thirds of participants (65.9%) had regular otological symptoms, most commonly water trapping (66%), hearing loss (48.2%), and cerumen impaction (35.7%). Less than one-fifth of the surfers (17.7%) reported regular use of protective equipment for EAE. The overall prevalence of exostosis was 71.8%, with most of the individuals having bilateral lesions (59%) and a mild grade (grade 1, 47.5%). There was insufficient evidence for any significant associations between the main outcomes (presence and severity of EAE) and factors related to age, surfing experience, winter exposure, surfing ability, symptoms, and use of protective equipment. CONCLUSION To the best of our knowledge, this is the first study assessing EAE in surfers exposed to warm waters (above 19 °C). The prevalence of 71.8% highlights the high prevalence of the condition in the surfing population, regardless of water temperature. Future research should focus on ways to prevent EAE.
Collapse
Affiliation(s)
- Vini Simas
- Water Based Research Unit, Bond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, Robina, 2 Promethean Way, Gold Coast, QLD, 4226, Australia.
| | - Wayne Hing
- Water Based Research Unit, Bond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, Robina, 2 Promethean Way, Gold Coast, QLD, 4226, Australia
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Evelyne Rathbone
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Rodney Pope
- School of Community Health, Charles Sturt University, Albury, NSW, Australia
| | - Mike Climstein
- Water Based Research Unit, Bond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, Robina, 2 Promethean Way, Gold Coast, QLD, 4226, Australia
- School of Health and Human Sciences, Southern Cross University, Gold Coast, QLD, Australia
- Physical Activity, Lifestyle, Ageing and Wellbeing, Faculty Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| |
Collapse
|
11
|
Impact of ear protection on occurrence of exostosis in surfers: an observational prospective study of 242 ears. Eur Arch Otorhinolaryngol 2021; 278:4775-4781. [PMID: 33555441 DOI: 10.1007/s00405-021-06609-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 01/05/2021] [Indexed: 01/17/2023]
Abstract
PURPOSE The aim of the study was to investigate the efficacy of ear protection (earplug and surf hood) in preventing the development of external auditory exostosis (EAE) in surfers. METHODS We performed a prospective observational study. Volunteer surfers were recruited from June 2016 to October 2017 on the Brittany coast in France. Each participant filled in a questionnaire and underwent otoscopic digitalized photography to establish the degree of external ear obstruction by two different practitioners. The correlation between the percentage of external ear obstruction and the time spent in water with or without protection was evaluated. Risk factors of EAE were assessed. RESULTS Two hundred and forty-two ears were analysed. The incidence of EAE was 89.96% with an average rate of obstruction of 37.65%. Risk factors for EAE were male sex (p = 0.0005), number of years practicing surf (p < 0.0001) and symptoms of ear obstruction (p = 0.0358). A significant correlation was found between EAE severity and number of hours spent in water without any protection (earplugs or surf hood) (p < 0.0001). No correlation was found between EAE severity and time spent in water with earplugs (p = 0.6711) but a correlation was identified between obstruction and time spent in water with surf hood (p = 0.0358). CONCLUSIONS Wearing earplugs is an effective way to prevent EAE in surfers unlike surf hood.
Collapse
|
12
|
Hanchard S, Duncan A, Furness J, Simas V, Climstein M, Kemp-Smith K. Chronic and Gradual-Onset Injuries and Conditions in the Sport of Surfing: A Systematic Review. Sports (Basel) 2021; 9:23. [PMID: 33572826 PMCID: PMC7911480 DOI: 10.3390/sports9020023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 01/04/2023] Open
Abstract
The majority of the previous literature investigating injuries in surfing have focused on acute or traumatic injuries. This systematic review appears to be the first to investigate the literature reporting on chronic and gradual-onset injuries and conditions in surfing populations. A search strategy was implemented on five databases in June 2020 to locate peer-reviewed epidemiological studies on musculoskeletal injuries or non-musculoskeletal conditions in surfing. A modified AXIS Critical Appraisal Tool was used to appraise all included texts. Extracted data included key information relevant to the epidemiology of the injuries and conditions. Twenty journal articles were included with the majority rated as good quality and a substantial agreement between raters (k = 0.724). Spine/back (29.3%), shoulder (22.9%), and head/face/neck (17.5%) were the most frequently reported locations of musculoskeletal injury, whilst the most common mechanism of injury was paddling (37.1%). Exostosis was the most frequently described injury or condition in surfing populations, with the most common grade of severity reported as mild obstruction. The key findings of injury type, location, severity, and mechanism can be used to develop relevant injury management and prevention programs for the surfing population, with an emphasis on chronic or gradual-onset spine/back and shoulder injuries, paddling technique, and education on the development and management of exostosis.
Collapse
Affiliation(s)
- Samuel Hanchard
- Water Based Research Unit, Faculty of Health Sciences, Bond University, Gold Coast, QLD 4207, Australia; (A.D.); (J.F.); (V.S.); (M.C.); (K.K.-S.)
| | - Ashley Duncan
- Water Based Research Unit, Faculty of Health Sciences, Bond University, Gold Coast, QLD 4207, Australia; (A.D.); (J.F.); (V.S.); (M.C.); (K.K.-S.)
| | - James Furness
- Water Based Research Unit, Faculty of Health Sciences, Bond University, Gold Coast, QLD 4207, Australia; (A.D.); (J.F.); (V.S.); (M.C.); (K.K.-S.)
| | - Vini Simas
- Water Based Research Unit, Faculty of Health Sciences, Bond University, Gold Coast, QLD 4207, Australia; (A.D.); (J.F.); (V.S.); (M.C.); (K.K.-S.)
| | - Mike Climstein
- Water Based Research Unit, Faculty of Health Sciences, Bond University, Gold Coast, QLD 4207, Australia; (A.D.); (J.F.); (V.S.); (M.C.); (K.K.-S.)
- Clinical Exercise Physiology, School of Health and Human Sciences, Southern Cross University, Bilinga, QLD 4225, Australia
- Physical Activity, Lifestyle, Ageing and Wellbeing, Faculty Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW 2006, Australia
| | - Kevin Kemp-Smith
- Water Based Research Unit, Faculty of Health Sciences, Bond University, Gold Coast, QLD 4207, Australia; (A.D.); (J.F.); (V.S.); (M.C.); (K.K.-S.)
| |
Collapse
|
13
|
Early specialized maritime and maize economies on the north coast of Peru. Proc Natl Acad Sci U S A 2020; 117:32308-32319. [PMID: 33288695 DOI: 10.1073/pnas.2009121117] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We assess diet and economies of middle Holocene (∼7,500 to 4,000 calibrated [cal] B.P.) humans at coexisting mound sites (Huaca Prieta and Paredones) in north coastal Peru and document regular consumption of maize by ∼6,500 to 6,000 cal B.P. and its earliest use as a staple food in this area of the Andes between 5,000 and 4,500 cal B.P. Stable isotope data from enamel carbonates and dentin collagen (childhood diet) and dental microwear texture analysis (adult diet) demonstrate dietary and economic specialization. Previous studies revealed maize and mixed-food refuse at both sites, but this study documents actual food consumption, showing that these communities situated a few hundred meters apart had significantly distinct diets in childhood and adulthood. Huaca Prieta focused on marine resources, although there are some contributions from terrestrial meat. Paredones individuals primarily consumed maize during childhood (up to 70% of the juvenile diet), as shown by δ13C values, apatite-collagen spacing, and discriminant analysis of δ13Ccoll, δ13Ccarb, and δ15N values. Maize was likely used as a weaning food (e.g., gruel and/or chicha-a maize beverage), hinting at the significant role of breastfeeding mothers, weanling infants, and children in the development of maize as a staple crop. Additionally, dental microwear data show Paredones adult diets are high in abrasives, potentially from maize processing. The distinct foodways at these neighboring sites result from and also reflect their social and political distinctions. These differences in food production, distribution, and consumption generated opportunities for exchange, an interaction that bound them together in mutual benefit.
Collapse
|
14
|
Lorentz KO. External auditory exostoses and early Neolithic aquatic resource procurement in Cyprus: Results from Cypro-PPNB Kissonerga-Mylouthkia in regional context. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2020; 30:98-104. [PMID: 32570055 DOI: 10.1016/j.ijpp.2020.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 06/07/2020] [Accepted: 06/07/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE This research is designed to evaluate the occurrence of external auditory exostoses (EAEs) in skeletal remains from the oldest known water wells in the world (Kissonerga-Mylouthkia, Cyprus, 8,200-7,200 BCE). MATERIALS Six individuals (MNI = 6), five fragmentary temporalia, two preserved auditory canals. METHODS Macroscopic and microscopic (up to x30) observation, with illumination; presence, type, side, severity, occlusion, number, and position of bony growths recorded. RESULTS Bony growths within two auditory canals were discovered. Differential diagnosis includes osteomata and external auditory exostoses, with the latter consistent with the bony growths (Grade 1 EAEs, two adult males, one with single, another with two EAEs). CONCLUSIONS The emergence of the Neolithic in Southwest Asia is thought to involve increases in dietary breadth among foraging societies (Broad-Spectrum Revolution). EAEs likely indicate maritime activity in this context, given the lack of freshwater bodies, and zooarchaeological evidence points to dietary and other uses of maritime organisms. SIGNIFICANCE This EAE evidence is the oldest known in maritime contexts in Eastern Mediterranean and the Middle East, and first in Cyprus. It contributes towards understanding the initial colonization events by Neolithic farming communities in the 9th millennium BC, and the emergence of broad-spectrum economies at the dawn of the Neolithic in Southwest Asia, crucial for re-considerations of paradigms on the transition to the Neolithic way of life in the Near East. LIMITATIONS Only a few skeletal remains from these prehistoric contexts were available for observation. SUGGESTIONS FOR FURTHER RESEARCH Further intensive review of Cypriot skeletal collections for EAEs is advised.
Collapse
Affiliation(s)
- Kirsi O Lorentz
- Science and Technology in Archaeology and Culture Research Center, The Cyprus Institute, Konstantinou Kavafi St, 2121, Aglantzia, Nicosia, Cyprus.
| |
Collapse
|
15
|
Transplantation of autologous oral mucosal epithelial cell sheets inhibits the development of acquired external auditory canal atresia in a rabbit model. Acta Biomater 2020; 110:141-152. [PMID: 32438108 DOI: 10.1016/j.actbio.2020.04.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 04/16/2020] [Accepted: 04/16/2020] [Indexed: 11/23/2022]
Abstract
Acquired external auditory canal atresia is characterized by fibrous tissue formation in the ear canal, hearing loss and chronic otorrhea. Although the disease can be treated surgically, the recurrence rate is high. This study explored whether autologous oral mucosal epithelial cell sheets could be used as a novel therapy for ear canal atresia. We succeeded in generating a rabbit model of acquired external auditory canal atresia by dissecting the skin of the ear canal. Endoscopic and histological findings in this model indicated that atresia developed over a 4-week period and was not inhibited by the placement of polyglycolic acid sheets immediately after skin dissection. By contrast, transplantation of autologous oral mucosal epithelial cell sheets, which had been fabricated by culture on temperature-responsive inserts without a feeder layer, prevented the development of atresia during the 4-week period after skin dissection. Transplantation of autologous epithelial cell sheets after surgical treatment of acquired external auditory canal atresia could be a promising new method to reduce the risk of disease recurrence. STATEMENT OF SIGNIFICANCE: Acquired external auditory canal atresia is characterized by fibrous tissue formation in the ear canal, which leads to hearing loss and chronic otorrhea. Although surgical treatments are available, the recurrence rate is high. In this study, we successfully generated a rabbit model of acquired external auditory canal atresia by dissecting the skin of the ear canal. Furthermore, we utilized this new animal model to investigate whether the transplantation of autologous oral mucosal epithelial cell sheets could be used as a novel therapy for ear canal atresia. Our results raise the possibility that the transplantation of autologous epithelial cell sheets after surgical treatment of ear canal atresia could be a promising new method to reduce the risk of disease recurrence.
Collapse
|
16
|
Simas V, Hing W, Pope R, Climstein M. Australian surfers' awareness of 'surfer's ear'. BMJ Open Sport Exerc Med 2020; 6:e000641. [PMID: 32153980 PMCID: PMC7047473 DOI: 10.1136/bmjsem-2019-000641] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2020] [Indexed: 11/05/2022] Open
Abstract
Objectives To assess awareness of external auditory exostosis (EAE) among Australian surfers. Methods This is a cross-sectional observational study, assessing professional and recreational Australian surfers. Currently, active surfers over 18 years of age, surfing year-round, were eligible to participate. After initial screening, individuals were asked to complete a questionnaire. All included volunteers underwent bilateral otoscopic examination, to assess the presence and severity of EAE. Results A total of 113 surfers were included in the study and were divided into two groups, based on surfing status: 93 recreational surfers and 20 professional surfers. Recreational surfers were significantly older (p<0.005), more experienced (greater years surfing; p<0.005), with lower prevalence of otological symptoms (p<0.05). The most common symptoms were water trapping, impacted wax and hearing loss. Prevalence of EAE was high for both groups (95% in the professional surfers and 82.8% in the recreational surfers); however, recreational surfers had mild grade EAE (grade 1) as the most common presentation, as opposed to professionals who had severe grade EAE (grade 3) as the most common presentation (p<0.05 between groups). Awareness of the term ‘surfer’s ear’ was high for both groups, as was knowledge of prevention options. However, fewer considered the condition to be preventable, and an even lower number reported regular use of prevention methods. Conclusion Australian surfers had a high level of awareness of EAE; however, few reported using prevention methods, despite having a high prevalence of the condition. Health practitioners should screen susceptible individuals in order to recommend appropriate preventive measures.
Collapse
Affiliation(s)
- Vini Simas
- Water Based Research Unit, Bond Institute of Health and Sport, Bond University, Gold Coast, Queensland, Australia
| | - Wayne Hing
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Rodney Pope
- School of Community Health, Charles Sturt University, Albury, New South Wales, Australia
| | - Mike Climstein
- Water Based Research Unit, Bond Institute of Health and Sport, Bond University, Gold Coast, Queensland, Australia.,School of Health and Human Sciences, Southern Cross University - Gold Coast Campus, Gold Coast, Queensland, Australia
| |
Collapse
|
17
|
The Prevalence and Severity of External Auditory Exostosis in Young to Quadragenarian-Aged Warm-Water Surfers: A Preliminary Study. Sports (Basel) 2020; 8:sports8020017. [PMID: 32033062 PMCID: PMC7077213 DOI: 10.3390/sports8020017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/23/2020] [Accepted: 01/26/2020] [Indexed: 01/22/2023] Open
Abstract
External auditory exostosis (EAE) has previously only been shown to occur in cold water surfers. We assessed young surfers living and surfing in Queensland, Australia, for EAE in water temp ranges from 20.6 °C (69.1 °F, Winter) to 28.2 °C (82.8 °F, Summer). All participants underwent a bilateral otoscopic examination to assess the presence and severity of EAE. A total of 23 surfers participated with a mean age of 35.4 years (8.3 years) and a mean surfing experience of 20.0 years (9.9 years). Nearly two-thirds of participants (n = 14, 60.9%) had regular otological symptoms, most commonly water trapping (n = 13, 56.5%), pain (n = 8, 34.8%), and hearing loss (n = 6, 26.1%). Only 8.7% (n = 2) of all surfers reported regular use of protective equipment (e.g., earplugs) on a regular basis. The overall prevalence of exostosis was 69.6% (n = 16), and the majority (n = 12, 80.0%) demonstrated bilateral lesions of a mild grade (<33% obstruction of the external auditory canal). This is the first study assessing EAE in young surfers exposed to only warm waters (above 20.6 °C). The prevalence of EAE in this study highlights that EAE is not restricted to cold water conditions, as previously believed. Warm water surfing enthusiasts should be screened on a regular basis by their general medical practitioner and utilize prevention strategies such as earplugs to minimize exposure to EAE development.
Collapse
|
18
|
External auditory exostoses among western Eurasian late Middle and Late Pleistocene humans. PLoS One 2019; 14:e0220464. [PMID: 31412053 PMCID: PMC6693685 DOI: 10.1371/journal.pone.0220464] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 07/16/2019] [Indexed: 01/26/2023] Open
Abstract
External auditory exostoses (EAE) have been noted among the Neandertals and a few other Pleistocene humans, but until recently they have been discussed primary as minor pathological lesions with possible auditory consequences. An assessment of available western Eurasian late Middle and Late Pleistocene human temporal bones with sufficiently preserved auditory canals (n = 77) provides modest levels of EAE among late Middle Pleistocene archaic humans (≈20%) and early modern humans (Middle Paleolithic: ≈25%; Early/Mid Upper Paleolithic: 20.8%; Late Upper Paleolithic: 9.5%). The Neandertals, however, exhibit an exceptionally high level of EAE (56.5%; 47.8% if two anomalous cases are considered normal). The levels of EAE for the early modern humans are well within recent human ranges of variation, frequencies which are low for equatorial inland and high latitude samples but occasionally higher elsewhere. The Early/Mid Upper Paleolithic frequency is nonetheless high for a high latitude sample under interpleniglacial conditions. Given the strong etiological and environmental associations of EAE development with exposure to cold water and/or damp wind chill, the high frequency of EAE among the Neandertals implies frequent aquatic resource exploitation, more frequent than the archeological and stable isotopic evidence for Middle Paleolithic/Neandertal littoral and freshwater resource foraging implies. As such, the Neandertal data parallel a similar pattern evident in eastern Eurasian archaic humans. Yet, factors in addition to cold water/wind exposure may well have contributed to their high EAE frequencies.
Collapse
|
19
|
Simas V, Remnant D, Furness J, Bacon CJ, Moran RW, Hing WA, Climstein M. Lifetime prevalence of exostoses in New Zealand surfers. J Prim Health Care 2019; 11:47-53. [PMID: 31039989 DOI: 10.1071/hc18097] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/07/2019] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION External 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. AIM To determine lifetime prevalence of EAE in New Zealand (NZ) surfers. METHODS This study used an online national survey. RESULTS Respondents 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. DISCUSSION Although 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.
Collapse
Affiliation(s)
- Vini Simas
- Water Based Research Unit, Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia; and Corresponding author.
| | - Debbie Remnant
- Osteopathy, Unitec Institute of Technology, Auckland, New Zealand
| | - James Furness
- Water Based Research Unit, Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | - Catherine J Bacon
- Osteopathy, Unitec Institute of Technology, Auckland, New Zealand; and Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Robert W Moran
- Osteopathy, Unitec Institute of Technology, Auckland, New Zealand
| | - Wayne A Hing
- Water Based Research Unit, Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | - Mike Climstein
- Water Based Research Unit, Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia; and School of Health and Human Sciences, Southern Cross University, Gold Coast, QLD, Australia; and Exercise Health & Performance Faculty Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| |
Collapse
|
20
|
Reis LR, Castelhano L, Correia F, Escada P. Contralateral Occlusion Test (COT): the effect of external ear canal occlusion with aging. Codas 2019; 31:e20180058. [PMID: 31017175 DOI: 10.1590/2317-1782/20192018058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 10/24/2018] [Indexed: 11/22/2022] Open
Abstract
PURPOSE This study aimed to evaluate the effects of complete external ear canal occlusion on hearing thresholds with aging. The goal was to decide which tuning fork is more appropriate to use for the contralateral occlusion test (COT), in individuals of different ages. METHODS Forty-two normal hearing subjects between 21 and 67 years were divided into three age groups (20-30 years, 40-50 years, and 60-70 years). Participants underwent sound field audiometry tests with warble tones, with and without ear canal occlusion. Each ear was tested with the standard frequencies (250, 500, 1000, and 2000 Hz). The contralateral ear was suppressed by masking. RESULTS Hearing thresholds showed an increase as the frequency increased from 20.85 dB (250 Hz, 20-30 years group) to 48 dB (2000 Hz, 60-70 years group). The threshold differences between occlusion and no occlusion conditions were statistically significant and increased ranging from 11.1 dB (250 Hz, 20-30 years group) to 32 dB (2000 Hz, 20-30 years group). We found statistically significant differences for the three age groups and for all evaluations except to 500 Hz difference and average difference. The mean hearing loss produced by occlusion at 500 Hz was approximately 19 dB. We found no statistically significant differences between right and left ears and gender for all measurements. CONCLUSION We conclude that the use of the 512 Hz tuning fork is the most suitable for COT, and its use may allow clinicians to distinguish mild from moderate unilateral conductive hearing loss.
Collapse
Affiliation(s)
- Luís Roque Reis
- Departamento de Otorrinolaringologia, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental - CHLO, NOVA Medical School, Faculdade de Ciências Médicas - Lisboa, Portugal
| | - Luís Castelhano
- Departamento de Otorrinolaringologia, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental - CHLO, NOVA Medical School, Faculdade de Ciências Médicas - Lisboa, Portugal
| | - Filipe Correia
- Departamento de Otorrinolaringologia, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental - CHLO, NOVA Medical School, Faculdade de Ciências Médicas - Lisboa, Portugal
| | - Pedro Escada
- Departamento de Otorrinolaringologia, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental - CHLO, NOVA Medical School, Faculdade de Ciências Médicas - Lisboa, Portugal
| |
Collapse
|
21
|
McParland A, Elffers-Tan F, Ackery A. Surfer's ear in a 29-year-old man. CMAJ 2019; 191:E396. [PMID: 30962199 DOI: 10.1503/cmaj.180753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Aidan McParland
- Faculty of Medicine (McParland), University of Toronto, Toronto, Ont.; University Medical Center Utrecht (Elffers-Tan), Utrecht, The Netherlands; Emergency Department (Ackery), St. Michael's Hospital, Toronto, Ont
| | - Frederique Elffers-Tan
- Faculty of Medicine (McParland), University of Toronto, Toronto, Ont.; University Medical Center Utrecht (Elffers-Tan), Utrecht, The Netherlands; Emergency Department (Ackery), St. Michael's Hospital, Toronto, Ont
| | - Alun Ackery
- Faculty of Medicine (McParland), University of Toronto, Toronto, Ont.; University Medical Center Utrecht (Elffers-Tan), Utrecht, The Netherlands; Emergency Department (Ackery), St. Michael's Hospital, Toronto, Ont.
| |
Collapse
|
22
|
Castano D, Comeau-Gauthier M, Ramirez-GarciaLuna JL, Drager J, Harvey E, Merle G. Noninvasive Localized Cold Therapy: A New Mode of Bone Repair Enhancement. Tissue Eng Part A 2019; 25:554-562. [DOI: 10.1089/ten.tea.2018.0191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Daniel Castano
- Division of Orthopedic Surgery, Department of Surgery, McGill University, Montreal General Hospital, Montreal, Canada
| | | | - Jose Luis Ramirez-GarciaLuna
- Experimental Surgery, Faculty of Medicine, McGill University, Montreal, Canada
- Bone Engineering Labs, Research Institute-McGill University Health Centre, Montreal General Hospital, Montreal, QC, Canada
| | - Justin Drager
- Division of Orthopedic Surgery, Department of Surgery, McGill University, Montreal General Hospital, Montreal, Canada
| | - Edward Harvey
- Division of Orthopedic Surgery, Department of Surgery, McGill University, Montreal General Hospital, Montreal, Canada
| | - Geraldine Merle
- Division of Orthopedic Surgery, Department of Surgery, McGill University, Montreal General Hospital, Montreal, Canada
| |
Collapse
|
23
|
Removal of external ear canal exostoses by piezo surgery: a novel technique. The Journal of Laryngology & Otology 2018; 132:840-841. [DOI: 10.1017/s0022215118001263] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackgroundExternal auditory canal exostoses are known to occur in patients who engage in cold-water sports. Although the majority of patients with exostosis remain asymptomatic, larger lesions can cause wax impaction, conductive hearing loss and predispose to recurrent otitis externa.ObjectiveA novel technique is described of using a piezo saw to excise exostoses that are symptomatic. The piezo saw is used to perform various procedures, but its use in removing exostoses has not been described in the literature.ConclusionExcision of exostoses of the ear canal using a piezo saw is a safe technique and patients have a speedy recovery. This paper describes a new technique for removing exostoses.
Collapse
|
24
|
Paddock M, Lau K, Raghavan A, Dritsoula A. Surfer's exostosis in a child who does not surf. Radiol Case Rep 2018; 13:531-533. [PMID: 29849851 PMCID: PMC5966629 DOI: 10.1016/j.radcr.2018.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 02/03/2018] [Indexed: 11/24/2022] Open
Abstract
Surfer's exostoses are more commonly seen in adults who frequently participate in aquatic activities with repeated exposed to cold water and wind. However, this entity has not been previously reported in the pediatric population. Most patients can be managed conservatively, particularly considering that surgical removal of external auditory canal exostosis can be challenging.
Collapse
Affiliation(s)
- Michael Paddock
- Department of Radiology, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield, S10 2TH, UK
| | - Kimberley Lau
- Department of Otolaryngology, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield, S10 2TH, UK
| | - Ashok Raghavan
- Department of Radiology, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield, S10 2TH, UK
| | - Aikaterini Dritsoula
- Department of Otolaryngology, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield, S10 2TH, UK
| |
Collapse
|
25
|
Trinkaus E, Wu XJ. External auditory exostoses in the Xuchang and Xujiayao human remains: Patterns and implications among eastern Eurasian Middle and Late Pleistocene crania. PLoS One 2017; 12:e0189390. [PMID: 29232394 PMCID: PMC5726651 DOI: 10.1371/journal.pone.0189390] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 11/26/2017] [Indexed: 11/30/2022] Open
Abstract
In the context of Middle and Late Pleistocene eastern Eurasian human crania, the external auditory exostoses (EAE) of the late archaic Xuchang 1 and 2 and the Xujiayao 15 early Late Pleistocene human temporal bones are described. Xujiayao 15 has small EAE (Grade 1), Xuchang 1 presents bilateral medium EAE (Grade 2), and Xuchang 2 exhibits bilaterally large EAE (Grade 3), especially on the right side. These cranial remains join the other eastern Eurasian later Pleistocene humans in providing frequencies of 61% (N = 18) and 58% (N = 12) respectively for archaic and early modern human samples. These values are near the upper limits of recent human frequencies, and they imply frequent aquatic exposure among these Pleistocene humans. In addition, the medial extents of the Xuchang 1 and 2 EAE would have impinged on their tympanic membranes, and the large EAE of Xuchang 2 would have resulted in cerumen impaction. Both effects would have produced conductive hearing loss, a serious impairment in a Pleistocene foraging context.
Collapse
Affiliation(s)
- Erik Trinkaus
- Department of Anthropology, Washington University, Saint Louis, MO, United States of America
- * E-mail:
| | - Xiu-Jie Wu
- Key Laboratory of Vertebrate Evolution and Human Origins, Institute of Vertebrate Paleontology and Paleoanthropology, Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
26
|
Barbon DA, Hegde R, Li S, Abdelbaki A, Bajaj D. Bilateral External Auditory Exostoses Causing Conductive Hearing Loss: A Case Report and Literature Review of the Surfer's Ear. Cureus 2017; 9:e1810. [PMID: 29308338 PMCID: PMC5749938 DOI: 10.7759/cureus.1810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
In patients with repeated exposure to cold water, such as cold water surfers and kayakers, the reactive exostoses can occur in the external auditory canal. The external auditory canal exostoses are multiple, benign bony growths. They can cause external auditory canal stenosis, leading to repeated otitis externa and potentially conductive hearing loss. It is vital to consider this entity in susceptible patients who report hearing loss, as timely intervention such as proper ear protection equipment can lower the risk of developing severe external auditory canal exostoses. We present a case of a 42-year-old male, cold water surfer with conductive hearing loss and bilateral external auditory canal (EAC) stenosis demonstrated on the computed tomography.
Collapse
Affiliation(s)
- Dennis A Barbon
- Frank H. Netter, Md School of Medicine, Quinnipiac University
| | - Rahul Hegde
- Department of Radiology, Yale New Haven Health at Bridgeport Hospital
| | - Shuo Li
- Department of Radiology, Yale New Haven Health at Bridgeport Hospital
| | - Ahmed Abdelbaki
- Diagnostic Radiology, Yale New Haven Health at Bridgeport Hospital
| | - Divyansh Bajaj
- Department of Internal Medicine, St. Vincent Medical Center, Bridgeport, Ct
| |
Collapse
|
27
|
Trinkaus E, Villotte S. External auditory exostoses and hearing loss in the Shanidar 1 Neandertal. PLoS One 2017; 12:e0186684. [PMID: 29053746 PMCID: PMC5650169 DOI: 10.1371/journal.pone.0186684] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 10/05/2017] [Indexed: 11/18/2022] Open
Abstract
The Late Pleistocene Shanidar 1 older adult male Neandertal is known for the crushing fracture of his left orbit with a probable reduction in vision, the loss of his right forearm and hand, and evidence of an abnormal gait, as well as probable diffuse idiopathic skeletal hyperostosis. He also exhibits advanced external auditory exostoses in his left auditory meatus and larger ones with complete bridging across the porus in the right meatus (both Grade 3). These growths indicate at least unilateral conductive hearing (CHL) loss, a serious sensory deprivation for a Pleistocene hunter-gatherer. This condition joins the meatal atresia of the Middle Pleistocene Atapuerca-SH Cr.4 in providing evidence of survival with conductive hearing loss (and hence serious sensory deprivation) among these Pleistocene humans. The presence of CHL in these fossils thereby reinforces the paleobiological and archeological evidence for supporting social matrices among these Pleistocene foraging peoples.
Collapse
Affiliation(s)
- Erik Trinkaus
- Department of Anthropology, Washington University, Saint Louis, Missouri, United States of America
| | - Sébastien Villotte
- UMR5199 PACEA, Université de Bordeaux–CNRS, Bâtiment B8, Allée Geoffroy Saint Hilaire, Pessac cedex, France
| |
Collapse
|
28
|
Rhys Evans PH, Cameron M. Aural exostoses (surfer's ear) provide vital fossil evidence of an aquatic phase in Man's early evolution. Ann R Coll Surg Engl 2017; 99:594-601. [PMID: 29022796 DOI: 10.1308/rcsann.2017.0162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
For over a century, otolaryngologists have recognised the condition of aural exostoses, but their significance and aetiology remains obscure, although they tend to be associated with frequent swimming and cold water immersion of the auditory canal. The fact that this condition is usually bilateral is predictable since both ears are immersed in water. However, why do exostoses only grow in swimmers and why do they grow in the deep bony meatus at two or three constant sites? Furthermore, from an evolutionary point of view, what is or was the purpose and function of these rather incongruous protrusions? In recent decades, paleoanthropological evidence has challenged ideas about early hominid evolution. In 1992 the senior author suggested that aural exostoses were evolved in early hominid Man for protection of the delicate tympanic membrane during swimming and diving by narrowing the ear canal in a similar fashion to other semiaquatic species. We now provide evidence for this theory and propose an aetiological explanation for the formation of exostoses.
Collapse
Affiliation(s)
| | - M Cameron
- East Sussex Healthcare NHS Trust , UK
| |
Collapse
|
29
|
Abstract
OBJECTIVE To describe a novel approach for excision of exostoses and evaluate the outcomes of transcanal excision of exostoses using ultrasonic serrated knife-assistance versus microosteotomes only. STUDY DESIGN Retrospective analysis. SETTING Academic Tertiary Care Center. PATIENTS/INTERVENTIONS Patients receiving a transcanal excision of exostoses between 2007 and 2016. MAIN OUTCOME MEASURES The outcomes and postoperative complications of 138 patients who received transcanal microosteotome only technique were compared to 10 patients who received transcanal excision of exostoses using ultrasonic serrated knife-assistance (Stryker Corporation, Kalamazoo, MI). RESULTS A total of 175 ears in 128 patients underwent a transcanal microosteotome only technique. Of these, 11 (6.3%) developed an intraoperative tympanic membrane perforation. One developed anterior canal mobilization requiring prolonged (3 wk) packing. One hundred thirty-five ears (77%) were well healed by the 3-week postoperative visit. All but one ear was well healed by the 6-week visit. In comparison, 11 ears in 10 patients were treated for exostoses using a transcanal approach with the use of ultrasonic serrated knife and microosteotomes. One ear canal (the first in the series) was not well healed by the 3-week postoperative visit due to suspected thermal injury. All patients had well-healed ear canals by 6 weeks, and there were no complications. CONCLUSION This is the first series to report the use of an ultrasonic serrated knife in the transcanal excision of exostoses. When compared with a transcanal microosteotome only excision of exostoses, the addition of the Sonopet seems to result in a similarly low complication rate. Sonopet can allow for more controlled transcanal excision of broad-based exostoses in patients with severe obstruction.
Collapse
|
30
|
Reis LR, Fernandes P, Escada P. Contralateral Occlusion Test: The effect of external ear canal occlusion on hearing thresholds. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017. [DOI: 10.1016/j.otoeng.2016.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
31
|
Reis LR, Fernandes P, Escada P. Contralateral Occlusion Test: The effect of external ear canal occlusion on hearing thresholds. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017; 68:197-203. [PMID: 28193471 DOI: 10.1016/j.otorri.2016.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 11/06/2016] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND GOALS Bedside testing with tuning forks may decrease turnaround time and improve decision making for a quick qualitative assessment of hearing loss. The purpose of this study was to quantify the effects of ear canal occlusion on hearing, in order to decide which tuning fork frequency is more appropriate to use for quantifying hearing loss with the Contralateral Occlusion Test. METHODS Twenty normal-hearing adults (forty ears) underwent sound field pure tone audiometry with and without ear canal occlusion. Each ear was tested with the standard frequencies. The contralateral ear was suppressed with by masking. Ear occlusion was performed by two examiners. RESULTS Participants aged between 21 and 30 years (25.6±3.03 years) showed an increase in hearing thresholds with increasing frequencies from 19.94dB (250Hz) to 39.25dB (2000Hz). The threshold difference between occluded and unoccluded conditions was statistically significant and increased from 10.69dB (250Hz) to 32.12dB (2000Hz). There were no statistically significant differences according to gender or between the examiners. CONCLUSION The occlusion effect increased the hearing thresholds and became more evident with higher frequencies. The occlusion method as performed demonstrated reproducibility. In the Contralateral Occlusion Test, 256Hz or 512Hz tuning forks should be used for diagnosis of mild hearing loss, and a 2048Hz tuning fork should be used for moderate hearing loss.
Collapse
Affiliation(s)
- Luis Roque Reis
- Department of Otolaryngology of Egas Moniz Hospital, Centro Hospitalar de Lisboa Ocidental (CHLO), NOVA Medical School - Faculdade de Ciências Médicas, Lisbon, Portugal.
| | - Paulo Fernandes
- Department of Otolaryngology of Egas Moniz Hospital, Centro Hospitalar de Lisboa Ocidental (CHLO), NOVA Medical School - Faculdade de Ciências Médicas, Lisbon, Portugal
| | - Pedro Escada
- Department of Otolaryngology of Egas Moniz Hospital, Centro Hospitalar de Lisboa Ocidental (CHLO), NOVA Medical School - Faculdade de Ciências Médicas, Lisbon, Portugal
| |
Collapse
|
32
|
Statecraft and expansionary dynamics: A Virú outpost at Huaca Prieta, Chicama Valley, Peru. Proc Natl Acad Sci U S A 2016; 113:E6016-E6025. [PMID: 27671633 DOI: 10.1073/pnas.1609972113] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Interpolity interaction and regional control were central features of all early state societies, taking the form of trade-embedded in political processes to varying degrees-or interregional conquest strategies meant to expand the polity's control or influence over neighboring territories. Cross-cultural analyses of early statecraft suggest that territorial expansion was an integral part of the process of primary state formation, closely associated with the delegation of authority to subordinate administrators and the construction of core outposts of the state in foreign territories. We report here on a potential case of a core outpost, associated with the early Virú state, at the site of Huaca Prieta in the Chicama Valley, located 75 km north of the Virú state heartland on the north coast of Peru. This site is discussed in the context of other possible Virú outposts in the Moche Valley, Pampa La Cruz, and Huaca Las Estrellas, and as part of a broader reflection on expansionary dynamics and statecraft.
Collapse
|
33
|
Awareness and attitudes towards external auditory canal exostosis and its preventability in surfers in the UK: cross-sectional study. The Journal of Laryngology & Otology 2016; 130:628-34. [DOI: 10.1017/s0022215116008082] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectives:To determine the proportion of UK surfers aware of external auditory canal exostosis, to identify surfer characteristics associated with knowledge of the condition and to explore attitudes to earplug use.Method:An online, cross-sectional survey of UK-based surfers.Results:Of 375 surfers, 86.1 per cent (n = 323; 95 per cent confidence interval = 82.3–89.3) reported awareness of external auditory canal exostosis. Further investigation revealed that, despite their awareness of the condition, 23.4 per cent of these surfers (88 out of 323; 95 per cent confidence interval = 19.5–28.0) had little or no knowledge about external auditory canal exostosis. Predictors of knowledge included: distance from nearest surfing beach (p = 0.001), surfing standard (ability) (p = 0.008), earplug use (p = 0.024) and positive external auditory canal exostosis diagnosis (p = 0.009).Conclusion:The findings suggest that a significant minority of UK surfers have no knowledge about this condition. Knowledge of external auditory canal exostosis was significantly associated with earplug use when surfing. Efforts to improve surfers’ knowledge are required to enable surfers to better protect themselves, which could reduce the incidence of external auditory canal exostosis.
Collapse
|
34
|
Abstract
Adventure and extreme sports often involve unpredictable and inhospitable environments, high velocities, and stunts. These activities vary widely and include sports like BASE jumping, snowboarding, kayaking, and surfing. Increasing interest and participation in adventure and extreme sports warrants understanding by clinicians to facilitate prevention, identification, and treatment of injuries unique to each sport. This article covers alpine skiing and snowboarding, skateboarding, surfing, bungee jumping, BASE jumping, and whitewater sports with emphasis on epidemiology, demographics, general injury mechanisms, specific injuries, chronic injuries, fatality data, and prevention. Overall, most injuries are related to overuse, trauma, and environmental or microbial exposure.
Collapse
Affiliation(s)
- Andrew Thomas Gomez
- Family Medicine, University of Washington, 331 Northeast Thornton Place, Box 358372, Seattle, WA 98125, USA
| | - Ashwin Rao
- Primary Care Sports Medicine Fellowship, Sports Medicine Section, Family Medicine, University of Washington, 3800 Montlake Boulevard, Box 354060, Seattle, WA 98195, USA.
| |
Collapse
|
35
|
|
36
|
Kim SH. Pre- and post-operative clinical findings of tympanomastoid surgery in female divers (Haenyeo) of Jeju Island with chronic otitis media. Acta Otolaryngol 2015. [PMID: 26224115 DOI: 10.3109/00016489.2015.1066936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS A tympanomastoid surgery can control chronic otitis media (COM) and improve hearing effectively in Jeju women divers (Haenyeo) without any complications. OBJECTIVE To evaluate the long-term results of tympanomastoid surgery in Haenyeo patients with COM to determine any link between their diving behavior and COM. METHODS The medical records of 207 COM patients who underwent tympanomastoid surgery were reviewed for demographic characteristics, etiologic analyses, pre- and post-operative hearing levels, types of tympanomastoid surgery with ossiculoplasty, and post-operative complications. The patients were divided into a 'Haenyeo COM group' of 98 patients and a 'general COM group' of 109, and followed up for at least 3 years. RESULTS In the audiologic study, the Haenyeo COM group showed a relatively larger pre-operative air-bone gap than the general COM group. There were no statistically significant differences in middle ear swab culture results, the rates of re-perforation of the tympanic membrane or re-operation, or the risk of post-operative complications between the two groups. However, the possibility of COM accompanying cholesteatoma was higher and the canal wall down mastoidectomy was more frequently performed in the Haenyeo COM group (both p < 0.05).
Collapse
Affiliation(s)
- Se-Hyung Kim
- a Division of Otology, Department of Otorhinolaryngology-Head and Neck Surgery, Jeju National University School of Medicine, Jeju National University Hospital , Jeju, Republic of Korea
| |
Collapse
|
37
|
Abstract
OBJECTIVES To establish the prevalence of external auditory canal exostosis ('surfer's ear') in Cornish surfers and investigate the potential impact on healthcare. METHOD A total of 105 surfers were interviewed and otologically assessed on popular Cornish beaches. The degree of exostosis was graded as mild, moderate or severe. RESULTS The prevalence of external auditory canal exostosis was 63.81 per cent (33.33 per cent mild, 18.10 per cent moderate and 12.38 per cent severe). The degree of exostosis showed a significant correlation with absolute cold-water exposure time. However, there was individual variation in susceptibility to external auditory canal exostosis; 12 per cent of surfers with excessive cold-water exposure showed no exostosis. Regression analysis of surgical operations performed at the Royal Cornwall Hospital for exostosis over the last 13 years revealed an average increase of 1.23 operations per year, with an average of 13 cases per year over the last 9 years. CONCLUSION Exostosis of the external auditory canal is common in Cornish surfers. There appears to be individual variation in terms of susceptibility to this condition. The possible reasons for this are discussed. The increase in the technically difficult surgical operations performed for exostosis is likely to have implications for health resources in the future.
Collapse
|
38
|
Lobo DR. Exostoses of the external auditory canal. World J Otorhinolaryngol 2015; 5:14-20. [DOI: 10.5319/wjo.v5.i1.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Revised: 12/31/2014] [Accepted: 01/19/2015] [Indexed: 02/06/2023] Open
Abstract
Ear canal exostoses are bilateral, usually symmetric multiple bony growths occurring in the medial portion of the external auditory canal. Also known as surfer’s ear, exostosis is thought to be a reactive process from repeated stimulation by cold water and is much more common than external auditory osteoma. Exostoses are usually asymptomatic and discovered on routine otoscopy. Indications for surgical treatment are recurrent otitis externa, hearing loss, otalgia and other conditions in which access medial to the exostoses is required. Surgery is not risk-free and postoperative complications are the most important factor for negative impact on the patient’s health-related quality of life. This review offers an overview of the recent advances in the understanding of this condition, with a special focus on the etiology and physiopathology of this condition, the different surgical procedures and their outcomes, the risk factors for recurrence and the results of preventive measures. Finally, this review suggests the need for the otological surgeon to acquire a great deal of experience before undertaking surgical treatment of exostoses as it is a challenging operation and, besides expertise, demands great patience and extreme care in order to achieve good results.
Collapse
|
39
|
Lennon P, Murphy C, Fennessy B, Hughes JP. Auditory canal exostoses in Irish surfers. Ir J Med Sci 2015; 185:183-7. [PMID: 25673165 DOI: 10.1007/s11845-015-1265-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 01/24/2015] [Indexed: 10/24/2022]
Abstract
AIM Surfing is increasing in popularity in Ireland. Exostoses of the external auditory canal are a common finding in those who surf in cold water. The aim of this study was to examine the prevalence of external canal exostoses in a population of Irish surfers. METHODS A cross-sectional study of Irish surfers was carried out. Patients were examined and questioned on their knowledge of exostoses, surfing routine, use of barrier protection and symptoms experienced. RESULTS 119 surfers were analysed. 66 % of the surfers examined exhibited exostoses and 88 % were unaware of their diagnosis. Those that developed exostoses had surfed for a mean of 5,028 h, those that did not had surfed for a significantly shorter mean of 1,909 h (p = 0.0002). CONCLUSIONS This is first study of this nature in the UK or Ireland. With a 5- to 6-year lag phase for exostoses to develop, these patients are likely to become an increasing part of Otolaryngologist's workload.
Collapse
Affiliation(s)
- P Lennon
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Limerick, Dooradoyle, Limerick, Ireland.
| | - C Murphy
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | - B Fennessy
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | - J P Hughes
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Limerick, Dooradoyle, Limerick, Ireland
| |
Collapse
|
40
|
Barrett G, Ronan N, Cowan E, Flanagan P. To drill or to chisel? A long-term follow-up study of 92 exostectomy procedures in the UK. Laryngoscope 2014; 125:453-6. [DOI: 10.1002/lary.24849] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 06/18/2014] [Accepted: 06/30/2014] [Indexed: 11/08/2022]
Affiliation(s)
- George Barrett
- Department of ENT-Head and Neck Surgery; Royal Cornwall Hospital; Truro United Kingdom
| | - Natalie Ronan
- Department of ENT-Head and Neck Surgery; Royal Cornwall Hospital; Truro United Kingdom
| | - Ewen Cowan
- Department of ENT-Head and Neck Surgery; Royal Cornwall Hospital; Truro United Kingdom
| | - Philip Flanagan
- Department of ENT-Head and Neck Surgery; Royal Cornwall Hospital; Truro United Kingdom
| |
Collapse
|
41
|
The effects of surfing behaviour on the development of external auditory canal exostosis. Eur Arch Otorhinolaryngol 2014; 272:1643-9. [PMID: 24619201 DOI: 10.1007/s00405-014-2950-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 02/10/2014] [Indexed: 10/25/2022]
Abstract
To examine how individual surfing behaviour affects the development of external auditory canal exostosis and to produce a model to predict exostosis severity. A standardised questionnaire was completed and each participant underwent an otoscopic examination. Surfers were recruited from August to October 2011 from surfing competitions and from colleges in the South West of England. 207 surfers were included, 53 % had evidence of external auditory canal; exostosis: grade 1, 23%; grade 2, 16%, grade 3, 16%. This risk of exostosis significantly increased with (1) surfing for 6 or more years, (2) surfing in the winter months, (3) surfing five or more times per month in the winter and (4) reported ear symptoms. Interestingly, participation in other water sports and wearing earplugs or a hood reduced the risk of developing exostosis. Surfers who surf in England are at significant risk of exostosis. A probability model was designed, incorporating different surfing behaviours and ear symptoms, the first of its kind in exostosis research. This model will be a useful tool for raising awareness of external ear canal exostosis in the surfing community and in assessing individual need for surgical intervention.
Collapse
|
42
|
Goto T, Tono T, Nakanishi H, Matsuda K, Ganaha A, Suzuki M. [Three cases of external auditory exostoses in a habitual sauna user]. NIHON JIBIINKOKA GAKKAI KAIHO 2014; 116:1214-9. [PMID: 24397119 DOI: 10.3950/jibiinkoka.116.1214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Exostoses are benign bony excrescences of the external auditory canal, commonly encountered in people who avidly engage in aquatic activities, hence the name "surfer's ear". Exostoses are more prevalent in cold water surfers, and additional years of surfing increase one's risk not only for developing an exostosis but also for developing more severe lesions. Exostoses remain clinically silent until they become large enough to impair the egress of epithelial debris and water from the canal, in which case there may be an associated external otitis and fluctuating hearing loss. Histologically, they demonstrate a laminated structure consistent with a periodic growth pattern. They may also cause a hearing loss by impinging upon the tympanic membrane and manubrium. Symptomatic relief is attained by surgical removal and skin grafting of the epithelially denuded areas of the bony walls of the external auditory canal. We report herein on 3 cases of exostoses which developed in patients who had a habit of taking a cold water bath after a hot sauna for more than 15 years: in spite of the limited time of exposure to cold water stimulation, alternating exposure to the hot environment of the sauna and cold water baths seemed to have acceralated the formation of the exostoses.
Collapse
Affiliation(s)
- Takashi Goto
- Department of Otorhinolaryngology, University of Miyazaki, Miyazaki
| | - Tetsuya Tono
- Department of Otorhinolaryngology, University of Miyazaki, Miyazaki
| | - Haruka Nakanishi
- Department of Otorhinolaryngology, University of Miyazaki, Miyazaki
| | - Keiji Matsuda
- Department of Otorhinolaryngology, University of Miyazaki, Miyazaki
| | - Akira Ganaha
- Department of Otorhinolaryngology, University of Miyazaki, Miyazaki
| | - Mikio Suzuki
- Department of Otorhinolaryngology, University of Ryukyu, Nakagami
| |
Collapse
|
43
|
Adelson RT, Kennedy DW. Paranasal sinus exostoses: possible correlation with cold temperature nasal irrigation after endoscopic sinus surgery. Laryngoscope 2012; 123:24-7. [PMID: 22893597 DOI: 10.1002/lary.23616] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 06/27/2012] [Accepted: 07/02/2012] [Indexed: 11/09/2022]
Abstract
Exostoses of the external auditory canal (EEAC) are a commonly encountered clinical exam finding; however, exostoses in other locations are vanishingly rare. The postoperative paranasal sinuses are penetrated with cold water solutions, the reputed etiological agent for EEAC, and development of exostoses in this unexpected location may be observed endoscopically. The surprising appearance of these protuberant lesions within the sinuses could be mistaken for more ominous processes, subjecting the patient to biopsy, surgery, or unnecessary medical therapy. The radiologic appearance of exostoses within the paranasal sinuses is herein reported for the first time, and care is taken to distinguish these bony lesions from the osteoneogenesis of chronic inflammation.
Collapse
Affiliation(s)
- Robert T Adelson
- Division of Rhinology, Department of Otorhinolaryngology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
| | | |
Collapse
|
44
|
Haffey T, Woodard T, Sindwani R. Paranasal sinus exostoses: an unusual complication of topical drug delivery using cold nasal irrigations. Laryngoscope 2012; 122:1893-7. [PMID: 22753257 DOI: 10.1002/lary.23384] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 04/02/2012] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS The use of topical drug delivery through nasal irrigations can minimize systemic side effects and deliver higher concentrations of drugs directly to diseased sinus mucosa. Complications related to this popular method of treatment are not well described. We present our experience with paranasal sinus exostosis (PSE), a new diagnostic entity that appears to be a complication of cold nasal irrigations. STUDY DESIGN Retrospective chart review. METHODS Retrospective chart reviews were performed on patients within the Cleveland Clinic Foundation from 2005 to 2011. Six patients were identified with sinus exostoses. A literature review for "sinonasal exostoses" and "paranasal sinus exostoses" was performed using PubMed. RESULTS Six patients with PSE were identified at the Cleveland Clinic Foundation between 2005 and 2011. All patients had undergone sinus surgery, and none had documented evidence of PSE prior to surgery. There was no evidence of worsening PSE once the cold irrigations were stopped. No patients showed any resolution of PSE over time. None of our patients has progressed to have disease burden significant enough to require intervention. CONCLUSIONS PSE is a rare condition that mirrors a well-described otologic process; exostoses of the external auditory canal. PSE appears to be a complication of cold nasal irrigations. It does not resolve with the halting of cold irrigations, but does not appear to progress further after intervention. PSE only affects postoperative patients. With the evolving trend to treat postoperative sinus disease topically, the clinician should be aware of the dangers of cold irrigations, and patients should be counseled accordingly.
Collapse
Affiliation(s)
- Timothy Haffey
- Section of Rhinology, Sinus and Skull Base Surgery, Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | | | | |
Collapse
|
45
|
White R, Ananthakrishnan G, McKean S, Brunton J, Hussain S, Sudarshan T. Masses and disease entities of the external auditory canal: Radiological and clinical correlation. Clin Radiol 2012; 67:172-81. [DOI: 10.1016/j.crad.2011.08.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 08/20/2011] [Accepted: 08/23/2011] [Indexed: 11/28/2022]
|
46
|
Nakanishi H, Tono T, Kawano H. Incidence of external auditory canal exostoses in competitive surfers in Japan. Otolaryngol Head Neck Surg 2011; 145:80-5. [PMID: 21493286 DOI: 10.1177/0194599811402041] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The objective of this study was to demonstrate the prevalence and severity of external auditory canal exostoses in a population of competitive surfers in Japan. The authors used a “surfing index,” the product of the period (years) as an active surfer and the frequency (number of surfing days per week), to predict external auditory exostoses formation. STUDY DESIGN Cross-sectional study. SETTING A total of 5 surfing competitions that were held in Miyazaki, Japan. MATERIALS AND METHODS The ear canals of 373 surfers with an average age of 33.1 years (range, 11-80 years) were examined with an otoscope. The severity of exostosis was classified into 4 groups, ranging from grade 0 to 3, according to otoscopic findings. Subjects also completed a questionnaire detailing their surfing habits. RESULTS There was a 59.8% overall prevalence of exostoses in 373 surfers. The incidences of grade 1, 2, and 3 exostoses were 118 (31.6%), 71 (19.0%), and 34 (9.1%), respectively. The prevalences of grade 2 and 3 exostoses were higher in surfers with a surfing index of more than 20 (P < .0001). CONCLUSIONS The authors determined that a positive association exists between the surfing index and the severity of exostoses. The findings suggest that it is possible to assume the likelihood of exostosis formation from the surfing index, and this may be of help to spread awareness of exostosis among surfers.
Collapse
Affiliation(s)
- Haruka Nakanishi
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Miyazaki, Japan.
| | | | | |
Collapse
|
47
|
Ramakrishnan JB, Pirron JA, Perepletchikov A, Ferguson BJ. Exostoses of the paranasal sinuses. Laryngoscope 2011; 120:2532-4. [PMID: 20979098 DOI: 10.1002/lary.21101] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
While bony exostoses of the external auditory canal have long been recognized as a complication of cold-water swimming, bony exostoses of the paranasal sinuses have not been previously reported. We present an unusual case of multiple exostoses of the paranasal sinuses, which began coincident with nasal irrigation with cold gentamicin solution. The patient had had prior endoscopic sinus surgery. Topical antibiotic gentamicin irrigation lessened recurrence of bacterial sinus episodes. He admitted to using the irrigation directly from the refrigerator daily for two years. A biopsy was consistent with exostosis. Patients should be counseled to avoid irrigating their paranasal sinuses with cold irrigants. Laryngoscope, 2010.
Collapse
Affiliation(s)
- Jeevan B Ramakrishnan
- Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
| | | | | | | |
Collapse
|
48
|
Crowe F, Sperduti A, O'Connell TC, Craig OE, Kirsanow K, Germoni P, Macchiarelli R, Garnsey P, Bondioli L. Water-related occupations and diet in two Roman coastal communities (Italy, first to third century AD): correlation between stable carbon and nitrogen isotope values and auricular exostosis prevalence. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2010; 142:355-66. [PMID: 20014179 DOI: 10.1002/ajpa.21229] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The reconstruction of dietary patterns in the two Roman imperial age coastal communities of Portus and Velia (I-III AD) by means of stable isotope analysis of bone remains has exposed a certain degree of heterogeneity between and within the two samples. Results do not correlate with any discernible mortuary practices at either site, which might have pointed to differential social status. The present study tests the hypothesis of a possible connection between dietary habits and occupational activities in the two communities. Among skeletal markers of occupation, external auricular exostosis (EAE) has proved to be very informative. Clinical and retrospective epidemiological surveys have revealed a strong positive correlation between EAE development and habitual exposure to cold water. In this study, we show that there is a high rate of occurrence of EAE among adult males in both skeletal samples (21.1% in Portus and 35.3% in Velia). Further, there is a statistically significant higher prevalence of EAE among those individuals at Velia with very high nitrogen isotopic values. This points to fishing (coastal, low-water fishing) as the sea-related occupation most responsible for the onset of the ear pathology. For Portus, where the consumption of foods from sea and river seems to be more widespread through the population, and where the scenario of seaport and fluvial activities was much more complex than in Velia, a close correlation between EAE and fish consumption by fishermen is less easy to establish.
Collapse
Affiliation(s)
- Fiona Crowe
- St Catherine's College, The University of Western Australia, Nedland, WA 6009, Australia
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Moore RD, Schuman TA, Scott TA, Mann SE, Davidson MA, Labadie RF. Exostoses of the external auditory canal in white-water kayakers. Laryngoscope 2010; 120:582-90. [PMID: 20066729 DOI: 10.1002/lary.20781] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES/HYPOTHESIS Exostoses of the external auditory canal are benign bony tumors associated with frequent cold-water exposure. Obstruction may lead to conductive hearing loss and recurrent otitis externa, requiring surgical correction when symptoms become intolerable. This study aimed to characterize the prevalence of exostoses in white-water kayakers and identify associated risk factors and protective measures. STUDY DESIGN Cross-sectional. METHODS Six hundred eleven white-water kayakers from across the United States were included in the study. Percent occlusion was graded as minimal (<25%), moderate (25%-75%) or severe (>75%). Subjects completed a survey of risk factors and protective measures. Kruskal-Wallis and chi(2) tests were performed to determine significant associations with percent occlusion. A multivariate proportional odds regression model was fit to adjust for confounding between the variables. RESULTS The prevalence of exostoses in kayakers was 79% (482/611); 13% (78/611) had >or=75% occlusion. Percent occlusion was associated with total years kayaked (P < .001), frequency >or=1 day/week (P < .001), male gender (P < .001), and increasing age (P = .005), although frequency, gender, and age were confounded by total years. Styles that involve repeated submersion were also associated with greater occlusion (freestyle, P = .036; squirt, P = .016). Subjects who used earplugs for a greater proportion of their kayaking career were less likely to have exostoses (P < .001). When adjusted for confounding, only total years (P = .0003) and age (P = .0027) remained significant. CONCLUSIONS Kayakers are the first inland population to experience exostoses at the rates seen in coastal populations (e.g., surfers). When used long-term, earplugs may be protective.
Collapse
Affiliation(s)
- Ryan D Moore
- Department of Otolaryngology-Head and Neck Surgery, and Vanderbilt University School of Medicine, Nashville, Tennessee 37232-8605, USA
| | | | | | | | | | | |
Collapse
|
50
|
Abstract
OBJECTIVES 1. To correlate exostosis severity with ear canal evaporative cooling. 2. To assess hearing and complications after canalplasty. STUDY DESIGN Retrospective chart review. SUBJECTS AND METHOD A retrospective chart review from 1990 to 2007 at a university tertiary referral center. RESULTS Surfers from the west coast of the United States were twice as likely to have severe exostoses in the right ear compared with the left. Evaporative cooling from a predominant northerly wind direction during the coldest water temperature months in this region may contribute to this lateral bias because surfers on this coast spend most of their time facing west. Few postoperative complications were identified. No cases of facial nerve injury or entry into the temporomandibular joint occurred. Differences in preoperative versus postoperative pure-tone hearing thresholds were not significant. CONCLUSION Exostosis severity seems to correspond to the ear that is more exposed to the predominant coastal wind. We propose that evaporative cooling in a cold water environment contributes to greater progression of exostoses in the ear with more exposure to the predominant wind. Exostosis removal using the postauricular approach carries a low complication rate.
Collapse
|