To be fair, there is no part of your body you'd want to find a tick nestled in for a long liquid lunch. But if there was any place you'd really consider out of bounds to a tiny bloodsucker, it's your eardrum. That's exactly what doctors found when a 9-year-old boy from Connecticut reported a strange sound in his right ear. Yep, cue wincing. There are two questions you really need to ask in a case like this. How did it get in there? And – far more importantly – how will it come out? According to Darius Kohan, director of otology at Lenox Hill Hospital in New York City, the ear canal is a perfect place for just about any creepy-crawly to slip inside. Kohan wasn't part of the medical team responsible for treating the patient, but he does know a thing or two about ears and the objects they attract. "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," Kohan told E.J. Mundell from HealthDay. To a tick, the warm, moist conditions and protected shelter of an ear canal would be just the place to hide. Exactly how this one got so far inside is a mystery, but it was most likely picked up while the young patient was playing outdoors. With no pain or loss of hearing, the only sign that something was amiss was a buzzing noise that persisted for several days. On investigation, this is what the attending doctor saw. Try not to make any crying sounds. For those who aren't familiar with the 900-odd species of tick on our planet, this one happens to be a prime example of an American dog tick, Dermacentor variabilis. Common across the US, these tiny arachnids dig mouthparts called capitulum into the skin of their host to hold on tight while they slurp up a generous belly full of blood. Most insects can be euthanised and flushed out with a good dose of warm mineral oil. Not this guy. That capitulum anchors it in place, and any attempt to yank it out isn't going to end nicely for either the tick or its host. According to the two physicians reporting on the case, David Kasle and Erik Waldman, an initial attempt was made to simply pluck the tiny intruder from the eardrum. "Removal of the tick with guidance from an operative microscope was attempted in the office, but the tick could not be removed," says their report. Thankfully they didn't try all that hard. The membrane making up the eardrum is a delicate piece of biological machinery. Tearing it wouldn't just cause the poor child immense pain, it would risk his hearing. Unfortunately leaving it in there also wasn't an option, risking infection and permanent damage to the eardrum. To do a proper job of evicting the tick, the physicians brought out the big guns and prepped the young man for 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," Kasle told CNN reporter Susan Scutti. The tale has a happy ending for all but the plucky Dermacentor variabilis. The boy was fine, with a perfectly intact eardrum and no signs of fever or rashes. And the doctors had a cool story to tell their grandkids. Maybe not as cool as the time doctors found a tick stuck a person's eyeball. No, really, you don't want to look. Ok, if you must. Cue more wincing. This research was published in the New England Journal of Medicine. Source
