Moth in the Left Ear

A 21-year-old healthy male presented to the emergency department with sudden onset of the left ear fullness and flipping wings sensation while riding a motorcycle passing a piece of grassplot. There was no otalgia, no tinnitus, no otorrhea, no hearing impairment, nor facial palsy documented. Physical examination revealed no auricle erythema nor tenderness. Upon otoscopic examination, an alive, white, 1.5-cm moth (Jankowskia taiwanensis) trapped in the end of the left external auditory canal was found (see Figure 1 and the video).

Figure 1.

Otoscopic examination found an alive, white, 1.5-cm moth.

After the topical anesthetic agent, 10% lidocaine was given, the moth was removed smoothly with forceps under the endoscopy. There was no ear drum perforation nor residual body of the moth in the external acoustic canal. The symptoms resolved immediately, and an antibiotic eardrop with ofloxacin was prescribed. On follow-up, no otologic sequela was stated.

Foreign body of the external acoustic canal should always be taken into consideration when aural fullness is the only complaint. The difficulty that insects have in walking backward may account for their inability to get out. The patient may state of hearing a buzzing sound, possibly along with otalgia, if the insect is alive. Scratching the skin of the ear canal, even damage or rupture of the eardrum, may occur if the patient tries to remove a foreign body by himself. Proper instrumentation and skill for foreign body removal in the emergency department or otolaryngology clinic is recommended.