A.T. Still University School of Osteopathic Medicine, Mesa, AZ, USA.
Department of Research Support, A.T. Still University, Kirksville, MO, USA.
J Osteopath Med. 2022 Mar 31;122(8):431-437. doi: 10.1515/jom-2021-0252.
External auditory canal exostoses (EACE) are bony formations that develop insidiously in the auditory meatus from chronic exposure to cold water and, in severe cases, require surgery. This condition has been understudied in the whitewater kayakers and not yet studied in the riverboarding population. Precautions such as earplugs are thought to prevent the formation of EACE because they mechanically block cold water from contacting the sensitive skin in the external auditory canal; however, earplugs are not commonly utilized by athletes. Inquiring about hobbies and the use of protective equipment can be done during osteopathic physicians' preventive care visits.
This article aims to determine the prevalence of EACE in Colorado whitewater athletes and their attitudes about wearing ear protection before and after an educational intervention directed at increasing awareness and prevention of EACE.
In July 2020, participants of this cross-sectional study completed a 10-min survey that collected demographics, whitewater experience, and perceptions of EACE, followed by an educational intervention. Participant ears were photographed utilizing a digital otoscope to assess EACE, and severity ratings were categorized into one of four occlusion levels: none (0%), mild (<25%), moderate (25-75%), or severe (>75%). Spearman correlation coefficients and Wilcoxon signed-rank tests were utilized to assess changes in attitudes before and after the educational intervention.
Eighty-one participants (mean [SD] age = 36.3 [12.6] years, 25.9% female) completed the study: 74 kayakers and seven riverboarders. After the intervention, 60.5% (49/81) (p<0.001) reported greater understanding of EACE and 75.0% (60/80) were more likely to wear ear protection (p<0.001). Most (58.0%, 47/81) never wore ear protection. Of the 61 (75.0%) participants with at least one ear severity rating, most (55.7%, 34/61) had moderate EACE, 29.5% (18/61) had no to mild EACE, and 14.8% (9/61) had severe EACE (p<0.001). Impaired hearing was the biggest barrier to utilizing ear protection (51.6%, 33/64).
Our results suggested that the educational intervention improved understanding of EACE and may increase utilization of ear protection in this population. Such prevention efforts may lead to better health of whitewater paddlers by reducing the incidence of EACE. Encouraging osteopathic physicians to inquire about hobbies and protective equipment during primary care preventive visits is essential to help keep athletes in the river doing what they love for longer, contributing to a healthier and happier whole person.
外耳道外生骨（EACE）是一种在听觉道内逐渐形成的骨形成物，由于长期接触冷水而引起，在严重的情况下需要手术。在白水皮划艇运动员中，这种情况研究得还不够多，而在漂流运动员中尚未进行研究。耳塞等预防措施被认为可以预防 EACE 的形成，因为它们可以机械地阻止冷水接触外耳道内的敏感皮肤；然而，运动员并不经常使用耳塞。在整骨医生进行预防保健访问时，可以询问运动员的爱好和使用防护设备。
本文旨在确定科罗拉多州白水运动员中 EACE 的流行率，以及在针对提高对 EACE 的认识和预防的教育干预前后，他们对佩戴耳部保护装置的态度。
在 2020 年 7 月，这项横断面研究的参与者完成了一项 10 分钟的调查，该调查收集了人口统计学、白水经验和对 EACE 的看法，然后进行了教育干预。参与者的耳朵使用数字耳镜拍照，以评估 EACE 的严重程度，并将严重程度分级为以下四个阻塞水平之一：无（0%）、轻度（<25%）、中度（25-75%）或重度（>75%）。利用 Spearman 相关系数和 Wilcoxon 符号秩检验评估教育干预前后态度的变化。
81 名参与者（平均[SD]年龄为 36.3[12.6]岁，25.9%为女性）完成了研究：74 名皮划艇运动员和 7 名漂流运动员。干预后，60.5%（49/81）（p<0.001）表示对 EACE 的理解有所提高，75.0%（60/80）更有可能佩戴耳部保护装置（p<0.001）。大多数人（58.0%，47/81）从未佩戴过耳部保护装置。在 61 名（75.0%）至少有一侧耳朵严重程度评分的参与者中，大多数（55.7%，34/61）有中度 EACE，29.5%（18/61）有轻度或无 EACE，14.8%（9/61）有重度 EACE（p<0.001）。听力受损是使用耳部保护装置的最大障碍（51.6%，33/64）。
我们的研究结果表明，教育干预提高了对 EACE 的认识，并可能增加了该人群对耳部保护装置的使用。这种预防措施可能通过降低 EACE 的发病率，从而改善白水皮划艇运动员的健康状况。鼓励整骨医生在初级保健预防访问中询问运动员的爱好和防护设备，对于帮助运动员保持健康和快乐，延长他们在河流中的活动时间，从而促进整体健康至关重要。
