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Dr. Hernan Goldsztein is now a full partner with Pacific ENT Medical Group, Inc.

Dr. Hernan Goldsztein was selected as a Top Doctor in Otolaryngology by his peers in 2017 and 2018 as featured in San Diego Magazine.

Dr. Moses Salgado and Dr. Hernan Goldsztein were featured as “Champions for Health” in San Diego Physician Magazine because of their volunteer work with patients in Project Access San Diego

Pacific ENT of San Diego County's Carlsbad * Treating Sinusitis * Sinus Surgery * Sleep *  Snoring * Sleep Apnea * Allergies * Ear Hearing & Balance * Voice * Head & Neck Surgical Care Allergist ENT Sinus Doctors of San Diego County California

EXOSTOSIS - Surfer's Ear

Exostosis, also known as surfer's ear, is a condition in which there is overgrowth of bone in the external ear canal. This results in narrowing of the diameter of the ear canal leading to water trapping, recurrent ear infections and eventually hearing loss. The most common cause of this condition is frequent exposure to cold temperatures such as from cold water when surfing or diving, or from cold wind while sailing or kayaking.

Once the bone growth occurs, it is irreversible. It may result in complete closure of the ear canal. It usually affects both ears, but may affect one side more than the other.

Treatment for early stages of this condition is protection from cold temperatures; using a hat, swim cap, hood or earplugs. Avoiding water exposure in the ear canals is important. Use of drops containing alcohol and vinegar or boric acid solution after water exposure, is helpful in preventing infection. Use of a blow dryer to dry the ear canal may also reduce the frequency of ear infections.

In more advanced stages, surgical removal of the bony growths is generally indicated. Indications for surgery are repeated ear infections and water trapping, hearing loss and development of cholesteatoma. Cholesteatoma of the ear canal may develop when earwax, debris and skin become trapped in the ear canal. This results in an expanding growth of skin, that causes a destructive process, involving the adjoining bone of ear canal and can progress to the middle ear and even the brain.

Hearing loss caused by advanced exostosis is usually reversible because it causes a conductive (sound cannot reach or be conducted to the inner ear) hearing loss rather than nerve loss.


Surgery to remove exostosis or surfer's ear is called canaloplasty. It is generally performed as an outpatient "same day" procedure at a surgery center. Most procedures are performed under general anesthesia. An audiogram (hearing test) is performed and a CT scan may be ordered prior to the procedure.

There are two approaches to the surgery. The first uses the natural opening of the ear canal to reach the growths and the second uses a small incision behind the ear (within the crease behind the external ear). A chisel and/or a surgical drill are used to remove the excess bone growths. On occasion, a small skin graft is used to cover the surface of the ear canal to help with healing. The size and location of the growths influence which approach the surgeon uses.


Most individuals may return to work and exercise in a few days after surgery. The ear canal must be kept dry during the healing process so, swimming and surfing should be avoided for 3-4 weeks after surgery. Post operative visits are generally scheduled 1 week and 1 month after the procedure.

Potential risks of canaloplasty include infection, especially if the ear is not kept dry, scar tissue formation and rarely, hearing loss. Regrowth of the exostosis occurs rarely, but may occur if there is repeated exposure to cold temperatures after surgery.

An Otolaryngologist is specifically trained and certified in the diagnosis, medical and surgical treatments for exostosis. Because of our location in North Coastal San Diego, we are fortunate to have gained a great deal of experience treating individuals with this condition. We look forward to helping treat others with surfer's ear.

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