Nasal leech infestation in children: comparison of two different innovative techniques

The objective of this study is to compare the results of two different techniques in removing nasal leech infestation.

This prospective study was carried out in 40 patients attending Department of ENT and Head and Neck Surgery, TU Teaching Hospital, Kathmandu, with the history suggestive of nasal leech infestation. Patients enrolled between April 2004 and December 2008 were studied. Patients were arranged randomly into two groups. In the first group of patients, anterior rhinoscopy was done and suction was used to remove the leech from nasal cavity. While in second group, water was poured into the kidney tray and adjusted 1cm below the nasal vestibule. As soon as the leech was seen in the nasal vestibule coming towards the water, they were catched with artery forceps. Both groups were compared in the following items: time taken to remove the leech, bleeding status, pain assessment and patient's/caretaker's satisfaction. Unpaired t test was applied to compare the time taken in removing leeches in both groups.

In the first group of patients using suction, the mean duration of removal of leech was 18.25 min while in second group of patients, it was 30.25 min. Bleeding and pain was present in the first group of patients. All children were not satisfied with this technique in first group of patients. Around 70% of the patients wanted an easier option to remove the leech from nasal cavity.

Wait and watch policy (keeping the water in kidney tray just below the nasal vestibule) is a better technique because of less pain and less blood loss with full satisfaction to the patients and caretakers, though it is more time consuming.