Dr. T. Balasubramanian M.S.
Synonyms: Myiasis narium; larva in the nose; Peenash
This is a common problem affecting patients in India. The
predisposting factors being:
1. Poorly nourished patient with poor
2. Patient's with atrophic rhinitis
3. Patient's with leprosy in the nose
4. Diabetics with purulent sinus infections
5. Midline granulomatous lesions involving the
6. Malignancy involving the nose.
7. Syphilitic disease involving the nose
Etiology: This condition is brought about by the
development inside the nasal cavity of larvae hatched from the eggs
already laid by certain flies. The commonest of them being Lucilia
hominivora or Sacrophaga Georginia. These flies get attracted by the
foul smelling stench eminating from the nasal cavity and lays their
eggs inside the nose of the patient. In addition to the stench these
patients have a relatively insensitive nose because the sensory
nerves are already damaged.
There is a tickling sensation and sensation of something
moving inside the nasal cavity. It is almost always associated with
sneezing, foul smelling sero sanguinous discharge. The patients may
have secondary infection of the nasal mucosa causing intense head
ache. Oedema of eye lids are also common. The pateint may go in for
septicemia. Worms can be seen coming out of the nasal cavity. If the
patient has septicemia then there may be associated fever with
chills. The patient may even become toxic and delirious. The mucous
membrane of the nasal cavity is destroyed, inaddition the cartilages
and bone also undergo necrosis.
of a patient with midline granuloma of nose from whom
maggots were removed
The use of various germicides inside the nasal cavity
must be condemned because of their effects on the nasal mucosa.
Liquid paraffin may be used to stiffle the worm. Liquid paraffin
blocks or chokes the lung of the maggots thereby killing them. The
killed worms can easily be removed. Chlorofom can also be used to
kill the migrating worm making their manual removal easy. With the
advant of the nasal endoscope complete removal of the worms is a
Video clip showing maggots from nose being removed
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