Tick in the outer ear canal: Two case reports

Although cases of foreign bodies in the outer ear canal are common in Ear, Nose and Throat clinics, cases of ticks in the outer ear canal are comparatively rare[1,2]. As of the 2000s, ticks have come to prominence as transmitters to humans of several diseases with poor prognosis, and particularly crimean congo hemorrhagic fever (CCHF). Ticks are non-flying and non-jumping ectoparasites that feed on blood and can infect all terrestrial vertebrates[3]. Other associated significant systemic diseases apart from CCHF are Lyme disease (Borrelia burgdorferi), tularemia (Francisella tularensis), typhus (Rikettsia conorii) and Q fever (Coxiella burnetii)[4]. Transmission of CCHF is directly proportional to the length of time the tick remains in the body, and mortality ranges between 3% and 30%[5]. The purpose of this paper was to discuss methods of removing ticks that enter the outer ear canal and what can be done at follow-up.