Growths of the Ear Canal (Osteomas and Exostosis)

Ear Canal Exostosis. Image from Wikipedia.

A not uncommon reason for an ENT visit are abnormal growths seen in the ear canal known as osteomas or exostoses. These growths are often found incidentally during a routine exam and are only found in the bony part of the ear canal, typically located a little over 1 cm past the ear canal opening.

Ear canal osteomas and exostoses are painless and non-cancerous. They are analogous to a foot bunion, but located in the ear. The vast majority of times, nothing needs to be done to treat or further test these growths. If it causes a problem, it typically is related to earwax buildup caught behind these growths as well as hearing loss if they get very large causing sound obstruction.

What differentiates an ear canal exostosis and an ear canal osteoma is location and appearance. An exostosis arises from the front or back of the ear canal bone. It is sessile meaning it looks like a rolling hill. An osteoma arises from the suture lines of the ear canal. It is pedunculated meaning it hangs from a thin stalk much like a clock pendulum. 

An osteoma may occur spontaneously, but most are associated with chronic cold water exposure from swimming or surfing while growing up. The colder the water and longer the exposure, the more likely they form and larger they become. 

Ear Canal Osteoma

If these growths trigger recurrent infections or hearing loss, surgical removal can be considered. A canalplasty is the procedure of choice which involves drilling the excess bone of the ear canal away. Occasionally, a skin graft may be needed to accommodate the newly opened ear canal.