An international surfing mecca, Santa Cruz is also distinctive as a world center for "surfer's ear," a serious condition that affects hearing. Medically known as "exostosis of the external auditory canal," surfer's ear is caused by repeated exposure to cold water and wind. Cooling of the ear canal stimulates bone growth that narrows the canal and blocks the eardrum. This narrowing traps water and earwax in the canal, often resulting in painful ear infections and hearing loss.
Douglas Hetzler, M.D. an ear, nose and throat specialist at the Santa Cruz Medical Clinic of the Palo Alto Medical Foundation, is one of a handful of California physicians using a minimally invasive technique to remove such bone growth.
- Diagram of a Surfer's Ear
- Surfers Heal Faster, Return to the Ocean Sooner
- Procedure Reduces Noise Level, Improves Healing
- How Can Surfers (and Ocean Swimmers) Avoid Surfer's Ear?
- Video of Procedure
Diagram of a Surfer's Ear
Below is a diagram showing the difference between a surfer's ear and a normal ear. The abnormal growth of bone narrows the ear canal of a surfer.
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Surfers Heal Faster, Return to the Ocean Sooner
Over the last 16 years Dr. Hetzler has operated on more than 1,200 ear canals afflicted with symptomatic bone growths by performing the surgery via the ear canal and using one-millimeter chisels. Dr. Hetzler has done presentations on the technique to other surgeons in the United States, Mexico, Australia and Ireland as a recognized expert in this procedure.
Two of those ears that he has done this procedure on belonged to Steve Spiliotopoulos, a well-known water sports enthusiast and manager of O'Neill Surf Shop in Santa Cruz. "I've been in the water for 30 years, since I was five -- swimming, boogie boarding, surfing and doing underwater photography from a dive boat. The cold water took its toll with over 95-plus percent closure in each ear," he said. "I would get earaches and infections from trapped water."
In January of 2002, Spiliotopoulos "bit the bullet" and underwent the surgery that he compares to oral surgery. "I was in and out the same day, had muffled hearing, throbbing and headaches for a couple of days, then was back to business as usual in four to five days, except for getting back in the water right away. I'm very happy with the procedure and Dr. Hetzler's follow up," Spiliotopoulos said.
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Procedure Reduces Noise Level, Improves Healing
In Dr. Hetzler's practice, using chisels to remove the ear canal exostoses via the ear canal has replaced the traditional incision behind the ear and all or most use of a drill. The advantages for the patient are less exposure to noise during surgery that can damage hearing, more rapid healing and a faster return to water sports.
"This technique is well-suited to a specific problem that is prevalent here," Dr. Hetzler said. "This surgery can be difficult because it's like looking through a keyhole, working in a space that is no bigger than seven millimeters -- the size of the end of your little finger at most."
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How Can Surfers (and Ocean Swimmers) Avoid Surfer's Ear?
"This condition develops over years of exposure to the cold," Dr. Hetzler said. "I've operated on people aged 17 to 85 for this condition, but most surfer's ear sufferers are in their late thirties. Prevention of the growth of the exostoses is aided by wearing earplugs and/or a neoprene hood when surfing or swimming in the ocean."