Myiasis of the head-neck region: a grossly underreported entity in the practice of otorhinolaryngology
Keywords:Dipterous larvae, Nasal myiasis, Atrophic rhinitis, Aural myasis, Maggots
Background: The term “myiasis” denotes a parasitic infestation of live human/vertebrate animal host by dipterous larvae of flies. In the head-neck region, the nasal cavity is most commonly involved. Risk factors include extremes of age, habit of sleeping outdoors in daytime and rural residence. The maggots have a tendency to burrow into host tissues with propensity to cause local/distant complications. There is paucity of clinical material on this subject suggesting that it is grossly under-reported. This study was performed to determine the patient profile, various sites of involvement, associated complications and response to treatment.
Methods: Detailed history was taken regarding relevant points followed by clinical examination in every case. Radiological investigation was advised whenever indicated. Daily removal of maggots was done endoscopically and patients were discharged only when they were maggot free on two consecutive days. All relevant information was noted in a standard case sheet.
Results: 20 patients were identified with female preponderance of 2.3:1. All patients hailed from lower socio-economic background and 85% had rural residence. Cases presented throughout the year with maximum incidence in summer. Most patients were in extremes of age. 80% had nasal cavity involvement followed by aural (15%) and tracheostomal involvement (5%). Complications were exclusively associated with nasal myiasis. Aural myiasis was seen exclusively in children.
Conclusions: Myiasis of the head-neck region appears to be an omnipresent health problem in the Indian subcontinent with propensity for complications if left untreated. It is a grossly under-reported condition with no standard treatment protocol.
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