Section 1

30 year old man is incidentally found to have the following:


Describe the picture.

Oto-endoscopic photograph of the left tympanic membrane with evidence of bony outgrowths in the external auditory canal

What is the diagnosis?

Bony exostosis

If symptomatic, describe two symptoms the patient may experience.

  • Conductive hearing loss
  • Wax build up and impaction
  • Otitis externa

What is the most likely precipitating factor?

  • Cold water exposure
  • Hence also colloquially called ‘surfer’s ear’

How might you prevent this condition from occuring?

  • Ear plugs, swimming cap
  • Water precautions

Describe the management of this condition.

  • Conservative – prevention, regular microsuction, treatment of any ear infections
  • Surgical – canaloplasty/excision of exostoses