A woman heard clicking and rustling for days. Doctors found a spider and its exoskeleton in her ear.

• A woman heard clicking, rustling, and beating sounds in her ear that kept her up at night.
• Doctors found a small spider and its exoskeleton in her ear canal.

A woman who heard "abnormal sounds" in her left ear discovered that a small spider had crawled inside and shed its exoskeleton.

The unnamed 64-year-old went to see an ear, nose, and throat doctor in Taiwan after four days because the "incessant beating, clicking, and rustling sounds," left her unable to sleep, according to a case report published on Wednesday in the New England Journal of Medicine. On the first day of symptoms, she had woken up with the feeling that a creature was in her ear, the report said.

During a physical exam of her left ear, doctors found a small spider and its exoskeleton in the external auditory canal, the tube that connects the outer part of the ear to the internal part. They removed it with a suction tube attached to an otoscope, the tool doctors use to look inside of the ear, and her symptoms immediately went away, the report said.

"She didn't feel pain because the spider was very small. It's just about two to three millimeters," Dr. Tengchin Wang, the report's co-author and the director of the otolaryngology department at Tainan Municipal Hospital, told NBC.

Her eardrum was normal, the report said, but if it was damaged or pierced, then the insect would need to be killed first to avoid further damage to the ear. This is done using local anesthetic to numb the area, and ethanol.

Most ear, nose, and throat doctors find a bug in someone's ear during their career

Finding foreign objects in people's ears is not uncommon for ear, nose, and throat specialists, and insects account for around 14 to 18% of these objects, according to a 2019 study. Cotton wool, pieces of paper, seeds, and beads are also common.

Most ENTs see "tens, if not more, of bugs or some sort of arthropod" in ear canals throughout their career, Dr. David Kasle, a physician at ENT Sinus and Allergy of South Florida, told NBC.

The external auditory canal is extremely sensitive, Kasle said. "Because of its sensitivity, you're obviously going to feel the crawling sensation, a tickle sensation that is almost unbearable."

If you think there is a bug in your ear, do not poke or prod it with a Q-tip because this could just push it down further, according to the Mayo Clinic. You could try pouring alcohol or warm, but not hot, olive, or baby oil into the ear and tilting your head down, but only if the eardrum is not damaged.

However, if the bug is difficult to get out or you are in pain, you should see a healthcare professional, according to the clinic.