Supiyaphun P, Sukumanpaiboon P
Department of Otolaryngology, Faculty of Medicine Chulalongkorn University, Bangkok, Thailand.
Auris Nasus Larynx. 2000 Jan;27(1):77-8. doi: 10.1016/s0385-8146(99)00035-8.
Acute otalgia during childhood is one of the most common complaints in general ENT practice. It may occur as a result of acute otitis externa, otitis media or a foreign body. Animate foreign body in the ear canal or in the middle ear usually results in otalgia and hearing loss. We present a rare case of a living mature termite in the middle ear of a 9-year-old girl complaining of intermittent attacks of otalgia associated with a loud cracking sound in the left ear. In this case, a small perforation of the tympanic membrane without a history of previous trauma, infection, or evidence of a foreign body in the external ear raises a suspicion. A careful, time-consumed microscopic examination could show the living creature in the middle ear. Immediate immobilization and removal of the living foreign body are imperative. In conclusion, tympanic membrane perforation and intermittent severe otalgia without history of otitis may lead to a suspicion of any insects in the middle ear.
儿童期急性耳痛是普通耳鼻喉科门诊最常见的主诉之一。它可能由急性外耳道炎、中耳炎或异物引起。耳道或中耳内有活动的异物通常会导致耳痛和听力损失。我们报告一例罕见病例，一名9岁女孩中耳内有一只活的成熟白蚁，她主诉左耳间歇性发作耳痛，并伴有响亮的爆裂声。在这种情况下，鼓膜出现小穿孔，且无既往外伤、感染史，外耳道也无异物迹象，这就引起了怀疑。仔细、耗时的显微镜检查可能会发现中耳内的生物。立即固定并取出活的异物至关重要。总之，鼓膜穿孔且无中耳炎病史却出现间歇性严重耳痛，可能提示中耳内有昆虫。
