Four Cases of Ticks in the External Auditory Canal

Cases of foreign bodies in the external auditory canal are frequently encountered in the field of otorhinolaryngology. However, there are few case reports of ticks in the external auditory canal. Ticks are known to parasitize humans and feed on blood, sometimes transmitting various infectious diseases, such as severe fever with thrombocytopenia syndrome, and when they are parasitic in the external auditory canal, prompt action is required. We encountered four cases of ticks in the external auditory canal. When removing a tick that has bitten the body, the mouthparts are likely to break off and remain on the skin, so that caution should be exercised. The most reliable method to remove a tick is to remove the tick along with the skin beneath under local anesthesia. Several materials and instruments have been used to remove ticks. Removal of ticks from the external auditory canal is especially difficult because the procedure is painful and the field of view is poor, which limits the use of instruments. It is important to understand the characteristics of ticks occurring as foreign bodies in the external ear and how to deal with them.