One day in April this year, a 64-year-old woman in Taiwan woke up in the morning and heard a rustling sound in her left ear. It felt like something was moving in her ear. At first she thought that maybe the sound would disappear after a while.
But in the days that followed, she heard more rustling sounds, as well as beating and clicking sounds.
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Haunted by these annoying sounds, the woman had trouble falling asleep every night.After four days of torture, she could no longer bear it and had to seek help from a doctor.
As a result, the doctor found a live spider in the woman’s ear canal, with its freshly shed old skin next to it.
live where there are people
The spider was not big, only 2-3 mm in size. When it was discovered, it was crawling in the patient’s external auditory canal.
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Dr. Wang Tieqing of Tainan City Hospital judged that it should be a Hasarius adansoni. This kind of spider belongs to the family Salticidae and is lively and bold. Unlike some other spiders that lie on their webs waiting for prey to come to them, they are hunters who actively stalk their prey and pounce on it.
Sand spiders like warm climates and can live in forests or on beaches, but the easiest place to find them is near human-inhabited houses.
Perhaps because the environment is relatively stable and there are plenty of insects for prey, the spiders can often be found in the courtyard outside the house or on the walls and tables inside the house.
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The English name of this jumping spider “Adanson’s House Jumper” also clearly tells the world that it will live in other people’s homes – naturally including the Tainan woman’s home.
As for the ears, there is probably a warm environment suitable for the spider, and the spider prefers dark places. The human ear canal also meets this condition. When the doctor saw the spider, it stretched freely in that space, and its movements were full of vitality.
Image source: original paper
Dr. Wang took a picture of the scene in the woman’s left ear, and she screamed when she saw it. In contrast, the doctor who often sees various foreign objects in the patient’s ears did not react as violently as the patient, but this case still seemed unusual to him.
Because the Huaha sand spider has completed molting in the patient’s external auditory canal, and Dr. Wang has never seen any insect molting in the human ear. As invertebrates, spiders, like many insects, do not have an internal skeleton to support the entire body, but are covered by a hard exoskeleton.
The exoskeleton supports the body structure, connecting various parts with joints, allowing the spider to move, and also serves as a protective barrier between the body and the external environment.
But as the spider gradually grows, the exoskeleton will not grow together. When this “armor” is not big enough, the spider will grow a new exoskeleton and take off the old armor. This is molting.
Molting is very important for the growth of a spider, but it is not an easy task. If the surrounding environment is not humid enough, the old exoskeleton may stick to the new exoskeleton before it is shed – failure to shed often means death for the spider.
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Judging from the results, the Hashasa spider successfully lost its old coat before being cleaned, which also means that the moist environment in the human ear is enough to support its smooth molting.
Later, the doctor used a suction tube to suck out the spider from the woman’s ear, and also used the same method to remove the spider’s exoskeleton.
Fortunately, the patient’s eardrum was not damaged, and because the spider was so small, the patient did not feel any pain. After the uninvited guest in her ear canal was removed, her symptoms immediately improved and she was able to go home.
Last month, Dr. Wang Tieqing and his colleagues published this case in the New England Journal of Medicine (NEJM).
They said that if a larger bug crawls into the ear canal, it may be necessary to kill the bug with lidocaine or ethanol first to prevent its excessive movement from causing damage to the ear structure. However, if the eardrum has been perforated, these liquids should not be used.
You thought it was cleaned up
Warmth, humidity, and darkness are not uncommon for bugs crawling into people’s ear canals. Compared to spiders, it would be even less surprising if cockroaches wandered into human ears.
In 2018, a woman named Katie Holley in Florida, USA, published her tortuous experience.
When Katie woke up one night, she noticed a strange feeling in her left ear, as if someone had put a piece of ice in her ear. Katie put a cotton swab into her left ear and felt something moving. She looked at the cotton swab again and saw insect legs on it. Katie’s husband shined a flashlight into the ear, confirmed that there was a cockroach in the middle of the ear canal, and tried to use tweezers to pick out the cockroach.
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He failed and only managed to get out two legs, but the insect’s body was still too deep. At this point, Katie and her husband’s handling of the matter is probably a typical example of mistakes in the eyes of professionals.
First, if a person suspects that there is a bug in his ear, if he pricks it with a cotton swab, it is likely to push the bug further away. Secondly, if ordinary people without special training use tweezers to pick out bugs in their ears at home, they may damage the eardrum, cause bleeding or infection, and may break the bug into multiple parts, making it more difficult to handle.
However, when the couple realized they couldn’t remove the cockroach on their own, they rushed to the emergency room overnight.
Doctors there used lidocaine to kill the cockroach in Katie’s ear and then used a pair of curved tweezers to remove the cockroach. To be precise, three pieces of cockroach were taken out. At this point, doctors believed there were no remnants of cockroaches in Katie’s ears.
But over the next week, Katie suffered recurring pain in her left ear and her hearing was affected. She sought help from her family doctor, and with the help of an assistant physician, she discovered that there were insect legs in her ears. This time, the doctor removed six more pieces of cockroach from her ear, but also reminded her that there were more.
Finally, an otolaryngologist, after removing the cockroach’s head, upper part of its torso, and some of its legs and antennae, assured Katie that nothing was left. At this time, 9 days had passed since the cockroach entered her ear.
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Photo credit: Katie Holley
Although the incident sounded horrifying and the woman suffered a lot during those nine days, the cockroach didn’t seem to be stuck in the most difficult position.
If the bug crawls into the ear and becomes embedded in the tissue, or is tightly stuck in the bony part of the ear canal, the situation becomes more complicated. The patient may feel unbearable pain if they are awake during the removal process, so sometimes it is necessary to Surgery was performed after general anesthesia.
One such case was published in 2019. A 9-year-old boy from Connecticut, USA, heard a buzzing in his right ear and felt like something was stuck in his ear after playing on campus one day. Three days later, the doctor who treated the boy discovered that a tick had burrowed into the tympanic membrane of his right ear, and the surrounding area was inflamed.
Image source: David Kasle & Erik Waldman (2019)
The tick was dead when it was found, with its head buried deep under the skin of the boy’s eardrum. If the tick is forcibly pulled out in the clinic, in addition to causing severe pain, it may also tear the eardrum, and relatively gentle operations will not make the tick move at all.
Finally, the boy was pushed into the operating room, and while the patient was under general anesthesia, the doctor used a right-angle hook to remove the bug under the guidance of an operating microscope. After the surgery, doctors continued to treat the wound in the boy’s ear with antibiotics. After about a month, the boy’s eardrum healed.
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The tympanic membrane (commonly known as the eardrum) plays an important role in human hearing. When sound waves are transmitted, the tympanic membrane vibrates, transmitting the signal to the ossicles, and then transmits the vibrations to the inner ear via the ossicular chain. Doctors said that if the tick is not removed, the boy’s eardrum may perforate, putting him at risk of hearing loss.
In addition, ticks pose a disease-transmitting risk to humans, and early removal can also help reduce the chance of disease transmission.
Regardless of the above situation, if you think you have bugs in your ears, it may be best to seek help from a doctor as soon as possible. This is what Dr. Wang, who helped the Tainan woman remove the spider, suggested.
And until you have a chance to see a doctor, at least don’t poke your fingers into your ears, don’t stick cotton swabs in, and don’t handle your ears with tweezers or paper clips. It may be itchy, and it may be difficult to resist picking your ears, but don’t do any of the above.
It may be better to use vegetable oil to help the bug slide out of the ear canal, or to turn the ear downward and gently shake the head. And most importantly, even if you are convinced that you have removed the worms, you should see a doctor because you may not have completely removed the worms.
references
[1]https://www.nbcnews.com/health/health-news/spider-found-inside-ear-canal-report-rcna121932
[2]https://www.washingtonpost.com/nation/2023/11/01/spider-in-ear-canal-taiwan/
[3]https://www.euronews.com/next/2023/10/26/woman-experiencing-rustling-noises-has-spider-and-its-exoskeleton-removed-from-her-ear
[4]https://exhibits.library.cornell.edu/arachnophilia/feature/growing-spiders
[5]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820391/
[6]https://www.nejm.org/doi/full/10.1056/NEJMicm1812049