Maggots in ear
From where does Maggots come in to human body? Do you have an answer?

A 55 years old lady had severe ear pain, giddiness for 2 days and met an ENT doctor in her native village . He had removed 4 maggots at his clinic and referred the patient to our hospital ENT department for further managementsince ours being a tertiary care centre.

The patient had a history of ear discharge from right ear for the past 6 months.On examination she had horizontal right beating Nystagmus suggestive of(R) Labyrinthitis and (R) CSOM with central perforation with active ear discharge. Maggots where seen coming out through the central perforation on the ear drum. She was admitted and started on Inj. Prochlorperazine and and T.Cinnarazine for her giddiness and IV fluids. She complained of severe pain which was persistent and not subsiding with pain killers. We removed 4 maggots on 1st day and 3maggots on 2nd day. The maggots kept coming from nowhere (only from middle ear which is less than 1cc). Her giddiness was persistent, vomiting and pain was getting aggravated as the days progressed. She being a known case of Diabetes was evaluated completely.

CT scan was to rule out intracranial and mastoid involvement. She was posted for cortical mastoidectomy, exploration and tympanoplasty under local anesthesia.

During the surgery 3 more maggots were removed through the central perforation. Cortical mastoidectomy was done. The ossicles were found to be intact but eroded may be partly due to disease process and partly due to the maggots. One maggot crawled very fast and tried to escape through the Eustachian tube. The maggot was removed partly using a cup forceps. The Eustachian tube was initially probed using the infant feeding tube. Since it was not passing through, the stillet of the central venous canula was used successfully and the Eustachian tube was catheterized. The remaining part of the maggot was pushed into nasopharynx by the cannula .A through wash using betadine was done. Temporalis fascia graft was harvested and placed by underlay technique.wound was closed in layers. In the post operative period the vertigo and pain subsided completely. She was discharged on 2nd post op day and revived on 7th pod. There was no maggots seen, patient was back to her routine daily work with no pain or giddiness which were her initial presenting symptoms. At present the eardrum is fully healed.

This surgery was done on Dec. 31st 2011 and was put in youtube on the eve of new year under the title “New year party by Monstors (Maggots) spoiled by ENT Doctor” and had 30,000 hits in a month. You can view the video in youtube inthe following address

view the video in youtube

Now the million dollar question is from where and how does maggots come in to the ear?

Only time can answer it.

The big question on internet is from where does the worms (maggots) that eat humans after death come from? No proper answer from anyone!

From the days of theory of spontaneous evolution to today no one is able to answer correctly.

Spontaneous generation is an obsolete principle regarding the origin of life from inanimate matter, which held that this process was a commonplace and everyday occurrence, as distinguished from univocal generation, or reproduction from parent(s). The hypothesis was synthesized by Aristotle, who compiled andexpanded the work of prior natural philosophers and the various ancient explanations of the appearance of organisms; it held sway for two millennia. It is generally accepted to have been ultimately disproven in the 19th century by the experiments of Louis Pasteur, expanding upon the experiments of other scientists before him (such as Francesco Redi who had performed similar experiments in the 17th century).

There is a view that maggots in the ear or nose is the larva of house fly. In that case housefly has to go in to ear or nose and lay eggs. It is a rubbish concept. (Any insect larva is called maggots). The maggots of ear, nose or dead body never turn into fly. We grew the maggots in decaying blood agar to see whether they turn into pupa or fly. No after few days they died as maggots itself. In fact the maggots eggs are airborne and present in every environment and whenever they come across a saprophytic environment it rapidly hatches to maggots and lay eggs which are again dispersed in air. (a better explanation).

Using maggots is some times faster than other non surgical methods for wound healing, and is not as likely to injure healthy tissues as is in our case it didn’t damage the normal middle ear structures.

Maggots within a wound are typically not a major danger (and in fact sometimes a good thing, as they seem to confine themselves to consuming only necrotic tissue). This gives you time to assess the situation and choose an effective, safe approach. Ideally flushing maggots from the wound with sterile saline works very well. Sterile saline is pretty harmless stuff and is used to remove pretty much any foreign material from open wounds. Alternately, in the case of a very small number of individuals, you can also remove maggots from a woundwith forceps.

If you have any good answer to how maggots get into dead bodies, ear or nose write to me .

Dr.N.Ahilasamy MS., MNAMS., DNB., FRCS.,DHA.,

Chief ENT, Head and Neck Surgeon.