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

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.