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Published online by Cambridge University Press: 05 November 2025
External auditory exostosis (surfer’s ear) is a progressive condition of benign hyperostotic overgrowths of the external auditory canal, secondary to repetitive cold-water exposure, in which symptoms correlate to degree of exostosis. Surgical intervention is the only available treatment, most commonly using the osteotome or microdrill, but these carry a risk of sensorineural hearing loss, post-operative stenosis, temporomandibular dysfunction and tympanic membrane perforation.
We describe in detail the Swansea technique, an innovative method of canaloplasty with endoscopic underwater excision of exostoses using a piezoelectric saw and continuous irrigation with 1:1,000,000 adrenaline, with the results from our first 34 procedures.
The inherent properties of the piezoelectric saw reduce the risk of overall complications when compared with traditional methods, whilst the surgical set-up is cost-equivocal and easily implemented in departments with endoscopic capabilities.
The piezoelectric saw is a promising novel technique for the treatment of external auditory exostosis.
Victoria Evans takes responsibility for the integrity of the content of the paper