Doctors in Taiwan used a suction tube inside an otoscope to remove a small spider and its moulted hard outer shell.
For four days, a 64-year-old woman heard strange sounds in her left ear, including beating, clicking and rustling noises.
The incessant sounds caused her to have problems sleeping.
She ended up at an ear, nose and throat specialist clinic, where a small spider was found in her left ear canal along with its moulted exoskeleton.
The finding was published in a short report in the New England Journal of Medicine on Wednesday.
Doctors in Taiwan removed the spider and exoskeleton with a suction tube that was placed inside an otoscope, a medical device used to look inside ears.
They said that for larger insects, using alcohol or a local anaesthetic to kill the insect first is recommended to prevent it from moving around and damaging the ear unless the eardrum has been perforated.
Dr Tengchin Wang, the doctor from the Tainan Municipal Hospital who treated the patient, told Euronews Next that it is common to find insects inside the ear since it is a tropical region.
In some cases, an insect "may damage the eardrum and cause eardrum perforation and some complications can happen. But in my case, the animal was very small so it didn’t damage the eardrum in my patient," he said.
There are often anecdotal reports of everything from ants to cockroaches being found in ear canals.
Livia Chan, an ear nose and throat physician assistant at Tufts Medical Centre in the US, told Euronews Next that it's not very common to see people with insects in their ears. Where she works, it happens less than once a year.
It's much more common to find foreign objects such as cotton fibres from a cotton swab that someone has put inside their ears.
"What happens is when you use cotton swabs to clean your ears, the head of it can break off or can get little cotton fibres stuck in your ears, so that's the most common thing," she said, warning people not to use cotton swabs inside their ears.
A study from University of Cincinnati researchers found that while most cases of insects in the ear canal are benign, “a small subset of patients can develop complications including infection, hearing loss and vestibular complaints related to the foreign body”.
Experts recommend that people should not try to remove any bugs from the ear with their fingers or cotton swabs. According to the Mayo Clinic in the US, you can pour alcohol or oil into the ear if there is no hole in the eardrum so the insect floats out.
Chan said however that "if you feel like there is a foreign object or an insect in your ear, you should seek professional help. Trying to do it yourself can cause a lot more damage".
This story was updated to include comments from an ear, nose and throat specialist.