Asian Journal of Case Reports in Surgery

Unusual Presentation of Tick in the Ear Causing Vestibulocochlear Nerve Involvement: A Case Report

A. M. Mohd Ridwan *

Department of Otorhinolaryngology, University of Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.

B. Mas Ayu

Department of Otorhinolaryngology, University of Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.

K. S. Balinder Singh Deol

Department of Otorhinolaryngology, University of Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.

G. Sakina

Department of Otorhinolaryngology, University of Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.

A. B. Zulkiflee

Department of Otorhinolaryngology, University of Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.

*Author to whom correspondence should be addressed.

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Abstract

Foreign body tick in the ear can cause facial nerve palsy due to toxins released by ticks affecting the facial nerve. Patients can come with symptoms of acute otalgia and the removal is difficult because it grips tightly to the ear canal or tympanic membrane. Other associated symptoms include symptoms of facial asymmetry, vertigo and sudden onset hearing loss if adherent to the tympanic membrane. This occurs likely due to involvement of facial nerve and vestibulocochlear nerve in view of toxins released by ticks. The involvement of vestibulocochlear nerve with foreign body ticks is rare. Herein, we report and discuss the management of a case of intra-aural tick resulting in facial nerve palsy and vertigo and sensorineural hearing loss.

Keywords: Tick, otalgia, facial palsy, vestibulocochlear nerve palsy

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