A Parasite Found in Boy's Eardrum Puzzled Doctors and Necessitated Surgery: True Incident

Tick attached to the tympanic membrane of the eardrum.Photo byNew England Journal of Medicine.

Imagine a tick burrowing into the most sensitive part of your ear—the eardrum. This nightmarish scenario became a reality for a 9-year-old boy from Connecticut, who reported a strange buzzing sound in his right ear.

A Creepy Intruder

Dr. Darius Kohan, director of otology at Lenox Hill Hospital in New York City, explains that the ear canal is an ideal hideout for tiny creepy-crawlies. Although Dr. Kohan was not part of the medical team treating the boy, his expertise in ontology (study of the ear) offers insights into why these invasions occur.

"We believe the wax in the ear attracts the bugs, and they get stuck behind hairs into the wax, or – like in this case – penetrate the skin or eardrum," Dr. Kohan said.

The warm, moist conditions of the ear canal make it an appealing shelter for ticks. How this tick managed to burrow so deeply into the boy's ear remains unclear, but it likely latched on while the boy was playing outdoors. Despite having no pain or hearing loss, the child experienced an incessant buzzing noise for several days.

The tick in question was an American dog tick, Dermacentor variabilis, a common species across the U.S. These arachnids anchor themselves to their hosts with their capitula while they feast on blood. Unlike other insects, which can be flushed out with warm mineral oil, this tick's grip on the eardrum posed a significant challenge.

A Delicate Operation

Initial attempts to remove the tick with an operative microscope in the office proved unsuccessful.

"Removal of the tick with guidance from an operative microscope was attempted in the office, but the tick could not be removed," physicians Dr. David Kasle and Dr. Erik Waldman reported in a case study published in The New England Journal of Medicine in 2019. Given the delicate nature of the eardrum, any forceful extraction risked causing immense pain and potential hearing damage.

Leaving the tick in place was not an option either, as it could lead to infection and permanent eardrum damage. To safely remove the tick, the doctors opted for surgery, the first of its kind in history. Although there were other cases of ticks found in the ear, none were severe enough to warrant surgery.

"We took him to the operating room, put him to sleep, and we were able to use pretty fine utensils to remove the capitulum of the tick," Dr. Kasle said.

The boy’s surgery was successful, with his eardrum remaining intact and no signs of fever or rashes. This incident serves as a reminder of the unusual places parasites can invade and the importance of prompt medical attention to avoid complications.