Unusual Foreign Body in the Middle Ear: Surgical Removal of a Live Ant Entering the Tympanic Cavity Through an Ear Drum Perforation

This case report details the unusual occurrence of a live ant invading the middle ear cavity through a pre-existing perforation in the tympanic membrane of a 42-year-old female patient. She presented to an outpatient clinic with symptoms of sudden-onset tinnitus ("ringing") and a foreign body sensation in her left ear. Otomicroscopy revealed an oval-shaped perforation in the posterior part of the left tympanic membrane, through which a dark, moving foreign object was observed in the middle ear. The object was identified as a live ant. Initial attempts to remove the insect under local anesthesia were unsuccessful, necessitating the patient's admission for surgery. Under general anesthesia, an endoscopic tympanotomy was performed, and the ant was successfully removed without complications. The patient recovered and was discharged the following day. At her follow-up appointment, she remained symptom-free. This case highlights the rare yet possible occurrence of live foreign bodies entering the middle ear through tympanic perforations and the need for timely surgical intervention to prevent complications.