ABSTRACT
BACKGROUND: Larvae of the sheep botfly (Oestrus ovis) normally have sheep or goats as host. In humans the larvae can survive for a short time in the nose or under the eyelids, after which they die or are sneezed out. CASE DESCRIPTION: We describe a 47-year-old woman who during a stay in the Cape Verde Islands developed symptoms of sneezing, a swollen face and an itchy feeling in her nose. These symptoms were due to an infestation of three fully-developed larvae of the O. ovis species in her sinus maxillaries which were later evacuated by endoscopy. CONCLUSION: In exceptional cases larvae of the O. ovis species can fully mature in a healthy person after a visit to an endemic area. Development into the mature stage has only been described in patients with a poor mucosal immune response.
Subject(s)
Diptera/growth & development , Myiasis/diagnosis , Sinusitis/diagnosis , Sinusitis/parasitology , Animals , Cabo Verde/ethnology , Female , Humans , Middle Aged , Myiasis/parasitology , Myiasis/surgery , Netherlands , Sinusitis/surgery , TravelABSTRACT
OBJECTIVE: To assess outgrowth and aesthetics of the nose in children after reconstruction of the cartilaginous nasal septum with autologous cartilage grafts on polydioxanone plate. DESIGN: Prospective nonrandomized case series. SETTING: University hospital. PATIENTS: Six patients (5 boys and 1 girl), aged 3 to 11 years, with nasal septal abscess. INTERVENTION: The nasal septa of 6 children with a history of nasal septal abscess and partial or complete destruction of nasal septal cartilage were reconstructed with autologous cartilage grafts of the auricle or rib fixed on polydioxanone plate. MAIN OUTCOME MEASURES: Nasal outgrowth was measured by the length of the nose and by the amount of nasal tip projection and was compared with standardized growth curves. Aesthetic outcome variables included nasolabial angle, columellar retraction, and development of saddle nose deformity and were classified as normal, mild, or severe. RESULTS: The duration of follow-up ranged from 10 to 68 months (mean follow-up, 38 months). Four children had complete loss of the cartilaginous septum. Areas 1 and 2 (caudal parts) had been destroyed in 2 children. Auricular cartilage was used in 5 children; costal cartilage was needed in 1 child. Compared with standardized growth curves, the length of the nose and the amount of nasal tip projection were within 1 SD in all children. None of the children developed saddle nose deformity. One child had mild columellar retraction; 3 children had mild overrotation of the nasal tip. CONCLUSION: Total reconstruction of abscess-induced destruction of nasal septal cartilage with autologous cartilage grafts fixed on polydioxanone plate has, so far, resulted in normal development of the nose during follow-up, without expected aesthetic problems.
Subject(s)
Abscess/surgery , Cartilage/transplantation , Nasal Septum/surgery , Polydioxanone , Prostheses and Implants , Rhinoplasty/methods , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Drainage , Esthetics , Female , Follow-Up Studies , Humans , Male , Maxillofacial Development/physiology , Nose Deformities, Acquired/diagnosis , Postoperative Complications/diagnosis , Prospective Studies , ReoperationABSTRACT
The cartilaginous part of the nasal septum of a child with a septal hematoma or abscess is at risk of destruction. Consequently, the noses of these children can collapse, causing a saddle nose deformity, and in time, the normal outgrowth of both the nose and maxilla will be disturbed. In adulthood, they will have an underdeveloped saddle nose deformity with too much upward rotation of the nasal tip and a retroposition of the midface. Sequelae like these should be prevented by prompt diagnosis and surgical intervention. In this article, the management of septal hematomas and abscesses is discussed with special focus on reconstruction of destructed septal cartilage with the use of autologous cartilage grafts fixed to a polydioxanon plate.
