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  • Writer's pictureSurfers Ear Clinic

Surfers Ear Issues: The Chisel Technique & All The Information You Need

Surfers Ear Clinic, Cape Town, South Africa.
Sound Levels

Why do we chisel surgeons make a big fuss about the alternative ie ‘drill’ surgery?

The main reason is this:

Research from the 1970’s suggests that the noise of a drill removing bone from the mastoid bone (the outer ear skull bone) is somewhere between 90 and 120 decibels (dB) in intensity.

We know that, according to occupational health standards and countless research articles and experimental studies, that at 100 dB the ‘safe’ period of noise exposure before damage to the cochlea is around 15 minutes.  At 120 dB it is only two minutes until permanent noise-induced hearing damage occurs.

An average ENT surgeon takes around three HOURS to drill exostoses from one ear, and this noise goes to BOTH cochleae.  An experienced drill surgeon might cut this time down, but cannot possibly work within the proven safety limits.  At best these will exceeded by at least a factor of four times, even in the best of hands.

So, the norm appears to be a total of six hours to drill both ears.  Some drill surgeons will do this in one setting. Consider this time relative to the ‘safe’ exposure time (somewhere between 2 and 15 minutes), and you start to understand our concern.

This extreme noise exposure explains why many people who have their ears drilled experience permanent tinnitus, and some will have permanent hearing loss as well.

These experiences have made thousands of surfers with troublesome ears refuse the surgery, and I understand that perfectly.

I willingly drill into an ear where there is chronic infection (mastoiditis) or a tumour, or a growth called a cholesteatoma, because these conditions have life-threatening complications, and hearing is of secondary importance.  The drill in these situations is the most appropriate tool, and can and must be used.

But surfers for the most part have normal ear drums, normal middle ear bones, and normal cochlear function and hearing … and their bone is extremely hard and situated right up against the eardrum, within a confined ear canal.  These factors stand to worsen the extent of noise damage when a drill is used.

It is for all these reasons that the chisel method in my opinion is to be far preferred. By a long shot.  Surfers who have had both methods done will unanimously say the chisel method was far easier to undergo.

The facts that we do both ears in one go, that there are no skin incisions, that recovery is quick and discomfort is minimal are all bonuses.The most important principle of all medical treatment, and surgery especially, is ‘to do no harm.’

Based on established, uncontested scientific facts, the drill method presents a significant risk of permanent hearing loss and/or tinnitus.

This might have been considered ‘acceptable’ before there was an alternative without those risks.  That situation has changed.  The few of us ENT's (twenty or so) worldwide who have embraced this technique have proved both its safety and efficacy.

Any surgeon who is prepared to drill away surfers ear bone should be willing to defend his/her decision and provide evidence that no harm will be done.I don’t think he/she can, based on both scientific and anecdotal evidence.

In my opinion there should be a moratorium on drill use for surfers ear, until such time that the research on drill noise is repeated and updated to give a clear contemporaneous assessment of the risks.

The onus to do this falls on the drill surgeons. 

We chisel surgeons have proven that the chisel technique is safe and effective and have thousands of happy surfer clients as a result.

At the moment it falls on surfers themselves to spread the word that the newer chisel technique poses a far easier recovery without the risks of the past. Read more about the Chisel Method with Dr Martin Young on our website and see our options for Medical Tourism. Contact: +27 44 382 0800


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