The New England Journal of MedicineImages in Clinical Medicine: A Spider and Its Exoskeleton in the Ear Canal

A Case of Unusual Foreign Body in External Auditory Canal

In a recent case, a 64-year-old hypertensive woman experienced an unusual auditory disturbance due to the presence of a spider in her ear. The patient, who presented to the otolaryngology clinic, reported abnormal sounds and sensations in her left ear, which were later found to be caused by a small spider.

Key Points

• The patient reported a 4-day history of abnormal sounds in her left ear.
• She described the sensation as if a creature was moving inside her ear.
• A small spider and its molted exoskeleton were found in the external auditory canal of the left ear.
• The spider and exoskeleton were successfully removed using a suction cannula placed through an otoscope.
• In cases of larger spiders or insects, instillation of lidocaine or ethanol is recommended before removal.
• Liquids should not be introduced into the ear if the tympanic membrane has been perforated.
• The patient’s symptoms immediately abated after removal of the spider and exoskeleton.

According to a study published in The Laryngoscope, foreign bodies in the ear account for 1.6% of all otolaryngologic emergency visits.

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