Pioneering Surgery for Surfer's Ear

An innovative surgical treatment can alleviate ear symptoms and get you back in the water.

Contributor

Douglas Hetzler, M.D.

Sutter Maternity & Surgery Center of Santa Cruz

Palo Alto Medical Foundation

If you’re one of thousands who take to the waves in California’s cold ocean waters, you’re at risk for surfer’s ear, bony growths in the ear canal that narrow it and block the eardrum. These growths trap water and wax inside the ear, causing painful ear infections and hearing loss.

Douglas Hetzler, M.D., an ear, nose and throat specialist with the Palo Alto Medical Foundation, pioneered a minimally invasive procedure that uses tiny chisels, instead of the usual drill, to remove bone growths. Dr. Hetzler’s approach, performed by only a handful of physicians, protects your ears from damaging drill noise and also gets you back in the water faster.

Building a Better Treatment

Back in the 1980s and ‘90s, Dr. Hetzler used the standard treatment for surfer’s ear, which involves drilling away the growths, called exotoses. “I started seeing a few patients who had high-frequency hearing loss after the surgery, and I thought, ‘What could have happened?’” Dr. Hetzler says.

When he realized drill noise caused the hearing impairment, Dr. Hetzler began developing new instruments and evolved the technique he’s used since 1998.

Using 1-millimeter chisels and working via the ear canal, this intricate technique offers many advantages. “With the chisel, it’s much easier to protect the skin, so people get faster healing and less postoperative pain. It also does not inflict the noise injury on people, and both ears can be done in one operation,” Dr. Hetzler says.

“Today, if somebody took my chisels away and said I had to drill, I wouldn't do the operation—it just poses too many risks,” he adds.

To date, Dr. Hetzler has performed surfer’s ear surgeries on more than 1,400 people (and 2,500 ears) from 26 states and 17 countries. He also teaches the procedure to doctors around the world.

Dr. Hetzler’s patients say they actually look forward to the surgery so they can get back to doing what they love. “Some of these people totally stop doing water sports because they’re so miserable with the water getting stuck in there and causing infections and hearing loss,” he says. “So to be able to fix that problem for them, they’re just ecstatic.”

How to Avoid Surfer's Ear

Surfer’s ear results from repeatedly exposing your ear canals to water colder than 68 degrees, which stimulates ear bone growth. Cold-water swimmers, divers and kayakers can also develop surfer’s ear.

Wear earplugs and/or a neoprene hood when enjoying the ocean to reduce your risk, Dr. Hetzler advises. The more years you play in cold water, the greater your chance of developing surfer’s ear.

Surgery, unfortunately, does not stop the bone from growing back. “If you’re good about using earplugs and keeping the cold water out, it can lessen the chance of it regrowing,” Dr. Hetzler says.