Not all people suffering from Surfer’s Ear may need surgery but it’s always good to know the treatment options available.
Surfer’s Ear is not only limited to surfer’s but the condition may occur in anyone who spends a lot of time in water. Here we answer 11 of your most frequently asked questions about the surgery for Surfer’s Ear.
1. Do I need the surgery?
Well, you have to be the one to make that decision. The benefits of getting Surfer’s Ear surgery has to be higher than the risks and negatives, and only you know how much of an issue your ears are to you.
2. What are the risks to me of putting off Surfer’s Ear surgery if I already have symptoms?
The biggest risk is that you reach a point where avoiding the surgery is really no longer an option due to your discomfort, hearing loss and repeated ear infections affecting everyday quality of life. At this point the risks of surgery may now be significantly higher, because the exostoses are bigger and require ‘more’ surgery under a more difficult situation where your eardrum may no longer be visible. In this instance your surgeon will be working ‘blind’ as to the location of your eardrum for the first and most crucial part of the surgery, and the risk of injury to your facial nerve, jaw joint, eardrum and middle ear structures are highest. These are as big concerns to your doctor as to you. While complications are rare, the worse your situation is, the more likely they are to occur.
A ‘difficult’ operation can take more than twice as long as an ‘easy’ operation. With theatre times as high as R300 a minute, this is obviously a factor in people who are not insured in any way for the surgery.
3. What would be the last point beyond which the surgery becomes harder?
While I can still see your eardrum past the exostoses, the surgery is easier. When the exostoses close up the canal completely, the surgery is harder to do. Not impossible by any means, and I still operate on those who want the surgery, but the procedure is definitely more difficult.
In essence, the sweet spot for having the surgery is when you are having symptoms, but before your ear canals are completely closed.
4. How long does the Surfer’s Ear surgery take?
It depends on how much bone needs to be removed, and how close the exostoses are to the drum. A rough estimation would be around one hour per ear. Many cases are significantly shorter than this. Some can take longer.
The relevance of this question is that many hospitals charge per minute for time in theatre, unless your doctor has negotiated a fixed rate beforehand. As I generally do. This has obvious implications on the cost of the procedure. Bank on two hours for both ears. This is substantially less than the time required for surgery using the drill.
5. Which ear do you do first?
I prefer to do the ear causing more symptoms first, on the assumption that it will be the trickier ear to do. If all goes well with that side, and with your agreement beforehand, I do the other ear at the same sitting.
6. Do I stay in hospital overnight?
Not unless you have a bad reaction to the anesthetic, with pain or nausea and vomiting. The vast majority of patients leave hospital the same day.
7. When do I need follow up after the surgery?
The biggest challenge in this surgery, and one we are still working on, is how to dress the ear canals after the operation with a minimal amount of discomfort and blockage, so that healing takes as little time as possible. The purpose of any checkups is to remove blood clots and scabs, and to get you back to normal as soon as possible.
The absolute minimum is a check up three days later to remove blood clots and dressings. The ideal would be another consultation about a week after the surgery.
Those whose schedules do not allow this should ideally have a backup with an ENT in their home towns. This consultation would be to remove crusts and scabs that are an inevitable part of healing. These will disappear without intervention, but this takes a bit longer.
8. Will the exostoses grow back?
Bluntly put, if you do not use ear plugs or a hoodie afterwards, yes.
If you were unlucky enough to get them in the first place, they will definitely come back again if you do not remove the cause, the ‘wet-cold-wind chill’ cycle that caused them in the first place.
9. Do medical insurers cover the surgery?
In general they do, unless they can show that you signed up with them with a pre-existing condition. In which case they may refuse.
The amount they pay out is dependent on your policy. Usually the hospital fees are covered in full, and this is about half the total cost. The surgeon and anesthetist fees are generally not covered in full, and I highly recommend that you get quotes and negotiate fees beforehand.
For those who can, ‘gap cover’ is a cheap insurance to cover those ‘self-payment gaps.’
10. What can I expect after surgery using the chisel technique?
For most people the worst thing to deal with will be a minor degree of discomfort and blocked ears until the dressings are removed after three days. There are some people who do find the surgery painful, but these are the minority, and medication is available to deal with this. I have no way of predicting who those people might be, unfortunately. Ringing in the ears – tinnitus – is common but will disappear as your ear canals heal.
11. How long before I can get back into the water?
I suggest you wait until all canal swelling is down, about two weeks. As long as your ears are protected with plugs to keep seawater out, surfing again should not be a problem. You will be using ear drops regularly anyway for at least a month after the surgery.
My goal with the chisel technique is to get you back into the water ASAP.
If you suffer from any ear, nose or throat problems don’t hesitate to see our ENT specialist, Dr Martin Young.