EAR COMPLICATIONS OF THE CRAWLING MAGGOTS

Objective: To assess the different complications of maggots invasion into the human ear by examination under microscope (EUM). Study Design: Prospective descriptive study. Settings: Department of Otorhinolaryngology, Quaid-e-Azam Medical College, Bahawal Victoria Hospital. Bahawalpur. Duration of Study: December 2012 to December 2013 (1 year). Material and Methods: We collected all cases of maggots in the ear coming to the emergency and out-patient departments of Bahawal Victoria Hospital meeting the inclusion and exclusion criteria during the duration of the study. After the formal permission from the hospital ethical committee these cases were entered in the study and the successful treatment of the disease in the form of complete removal of all the maggots from the ear was achieved in the inpatient department. After that we assessed the different com-plications produced by the maggots by doing examination under microscope. The findings were noted and recorded on a prescribed questionnaire. Results: There were a total of twenty (20) cases with maggots in the ear. Ten patients were males and ten were females (50%). Fifteen patients (75%) were below five years of age, four patients (20%) were from six to ten years of age and one patient was above 11 years. All twenty patients (100%) gave the history of ipsilateral ear discharge and pain in the ear. Bleeding was present in seventeen patients (85%). Thirteen patients (65%) had hearing difficulty. Only one patient (5%) was mentally retarded. All patients (100%) belo-nged to poor socioeconomic class. One patient (5%) was having bilateral maggots in his ears. Excoriation of the skin of pinna was found in fourteen patients (70%), and one patient (5%) had skin loss of part of auricle. In the external auditory canal, ten patients (50%) had bruising and ten had skin ulceration (50%). Tympanic membrane perforation was found in thirteen patients (65%). Out of these thirteen patients with perforated drums, five patients (38.4%) were having middle ear granulations. Conclusion: Maggots ear also known as aural myiasis involves poor malnourished children and young adults. It can be responsible for variable degree of damage to the structures of human ear causing important complications. Improving the hygiene, nutritional status and treating the underlying ear disease, this problem can be overcome easily.