It started with a strange sensation in her left ear: the feeling of movement, followed by incessant clicking and rustling sounds.
After struggling to sleep for several nights, the 64-year-old woman in Taiwan visited an ear, nose and throat clinic. There, doctors discovered a small spider moving about her ear canal. It had discarded its exoskeleton, which sat nearby.
Doctors in April used a tube to suction out the spider and exoskeleton, according to a case report published Wednesday in the New England Journal of Medicine.
“She didn’t feel pain because the spider was very small. It’s just about 2 to 3 millimeters,” said Dr. Tengchin Wang, the report’s co-author and the director of the otolaryngology department at Tainan Municipal Hospital. (Two-and-a-half millimeters is about one-tenth of an inch.)
Wang said he wrote the report because of the case’s novelty: He had seen ants, moths, cockroaches and mosquitoes inside people’s ears before, but never an insect that molted inside an ear canal.
He urged the public to see a doctor if they ever experience such symptoms.
Discovering an insect inside a person’s ear is rare but not unheard of, doctors in the U.S. say.
Most ear, nose and throat specialists see “tens, if not more, of bugs or some sort of arthropod” in ear canals throughout their career, according to Dr. David Kasle, a physician at ENT Sinus and Allergy of South Florida, who wasn’t involved in the new research.
However, the image in Wang’s report is “unusual and disturbing,” Kasle said.
Past research suggests that live insects represent at least 14% of foreign objects found in people’s ear canals. Other commonly identified objects include cotton balls, beads and earring backings.
In 2020, doctors found a Japanese beetle inside the ear of a 14-year-old girl in Pennsylvania. She had been swimming in a pool, then detected a crawling sensation in her right ear.
The year before, a 9-year-old boy in Connecticut reported buzzing noises in his right ear, which prompted Kasle and a colleague to discover a tick lodged in the boy’s eardrum.
While children may have a harder time distinguishing a bug in their ear from a general earache, adults should be able to tell right away.
“There’s an extremely sensitive, thin layer of skin that lines the ear canal called the external auditory canal,” Kasle said. “Because of its sensitivity, you’re obviously going to feel the crawling sensation, a tickle sensation that is almost unbearable.”
Dr. Stacey Ishman, an otolaryngology instructor at the University of Wisconsin School of Medicine and Public Health, estimated that she has treated about eight patients with insects in their ears over her 23-year career — often people who did outdoor activities like camping.
“Most of the time the ear is completely fine,” said Ishman, who also wasn’t involved in the new report. “If there’s some injury to the ear canal, quite honestly it’s more often from people trying to get it out than it is from the bug itself.”
People who suspect a bug may be inside their ear shouldn’t stick their finger inside because the insect could sting them, according to the National Library of Medicine. Nor should they use tweezers or a paperclip, since such instruments can damage the eardrum or cause bleeding or infection. Ishman further cautioned against putting a Q-tip in the ear, which can lodge the insect in farther.
A safe option, according to doctors, is to pour vegetable oil, olive oil or baby oil into the ear to drown the bug or help it slide out. Doctors also suggest tilting your ear to the ground and shaking your head to get the bug to exit on its own.
In the new report, Wang recommended using lidocaine or ethanol to kill larger insects, thereby stopping them from moving and damaging the ear. That step should be avoided, however, if a person’s eardrum has a hole in it — which may be hard for people to determine on their own.
Even those who’ve removed an insect from their ear should see a doctor, Ishman said, because parts of the bug — like an antenna —could be left behind.
“We can get a really up-close view and we can make sure everything’s thoroughly removed,” she said.
