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Palatal Perforation Due to Nasal Myiasis in a Patient With Atrophic Rhinitis: A Case Report
Aayucee Agrawal1, Shivam Pandey1, Krishnandan Shah2
1B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
Abstract:
Atrophic rhinitis (AR) is a chronic nasal disease characterized by atrophy of the nasal mucosa and turbinates. Occasionally, nasal myiasis complicates AR. This case illustrates an uncommon complication of nasal myiasis, palatal perforation. A 35-year-old South Asian woman presented with recurrent bilateral epistaxis and expulsion of maggots from the nose. She had a history of nasal obstruction, foul-smelling nasal discharge, and anosmia. On examination, the patient had atrophied nasal turbinates and later developed 2 perforations in the palate. She was offered conservative management for AR. Besides, she underwent manual and endoscopic removal of maggots in multiple settings and was isolated in a mosquito net to prevent reinfestation. Nasal myiasis can complicate AR in tropical regions. Early diagnosis of AR and simple prophylactic measures, such as nasal douching and use of mosquito nets while sleeping, can prevent complications such as palatal perforation and intracranial extension caused by nasal myiasis.
Insights
Nasal myiasis, a rare complication of atrophic rhinitis (AR), can lead to severe issues like palatal perforation. Early diagnosis and simple preventive measures are crucial for managing this condition.
Area of Science:
- Otolaryngology
- Infectious Diseases
Background:
- Atrophic rhinitis (AR) is a chronic nasal condition.
- Nasal myiasis, infestation by fly larvae, can occur as a complication of AR.
Purpose of the Study:
- To report an uncommon complication of nasal myiasis in a patient with atrophic rhinitis.
- To highlight the importance of early diagnosis and prevention of nasal myiasis.
Main Methods:
- A case study of a 35-year-old woman with atrophic rhinitis and nasal myiasis.
- Clinical examination, maggot removal (manual and endoscopic), and conservative management for AR.
Main Results:
- The patient presented with epistaxis and maggot expulsion, later developing palatal perforations.
- Successful maggot removal and management of AR symptoms were achieved.
Conclusions:
- Nasal myiasis is a potential complication of atrophic rhinitis, particularly in tropical regions.
- Preventive measures like nasal douching and mosquito nets can avert severe complications such as palatal perforation.
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