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INTERNATIONAL JOURNAL
OF CURRENT RESEARCH
International Journal of Current Research
Vol. 10, Issue, 04, pp.68578-68580, April, 2018

ISSN: 0975-833X
RESEARCH ARTICLE

MAGGOTS: A DOOM AND BLOOM IN COUNTRIES WITH POOR ORAL HYGIENE

*Dr.
Dr. Wasim Pathan, Dr. Bhawana Narla, Dr. Apoorva Iyengar,
Dr. Kalyani Gelada and Dr. Viren Patil
Bharati Vidyapeeth Dental College and Hospital, Pune, India

ARTICLE INFO ABSTRACT

Article History: Oral myiasis is a rare condition caused by the invasion of the tissues of larvae of flies. As we present a
th
Received 17 January, 2018 case of oral maggots in a 53 year old male, the patient did not maintain oral hygiene post surgery of
Received in revised form Hemimandibulectomy reconstructed with PMMC flap.
26th February, 2018
Accepted 10th March, 2018
Published online 30th April, 2018

Key words:
Larvae, Flap failure, Oral hygiene,
Plate exposure, Maggots.

Copyright © 2018, Wasim Pathan et al. This is an open access article distributed under the Creative Commons Attribution
ribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original work is properly cited.

Patil, 2018. “Maggots: a doom and bloom

Citation: Dr. Wasim Pathan, Dr. Bhawana Narla, Dr. Apoorva Iyengar, Dr. Kalyani Gelada and Dr. Viren Patil
in countries with poor oral hygiene”, International Journal of Current Research,
Research 10, (04), 68578-68580.

INTRODUCTION An incisional biopsy was carried out under local anaesthesia,

The term myiasis (Greek: myi= = fly) is for referred for the
infestation of living tissues of humans and animals, by
diptereous eggs or larvae (Millikan,, 1999). The oral cavity is
rarely affecting by this infestation (Pindborg
Pindborg, 1992) and the
oral myiasis has been associated with poor oral o hygiene,
alcoholism, senility, supuranting lesions, severe halitosis
hali and
others conditions (Millikan, 1999; Pindborg,
Pindborg 1992; Hall and
Wall, 1995; Felices and Ogbureke, 1996; Gomez et al., 2003).
The myiasis can be classified as obligatory, when larvae
develop
evelop in living tissue, or facultative, when maggots feed on
necrotic tissue. The obligatory myiasis is more harmful for the
humans. The most common anatomic sites for myiais are the
nose, eyes, lungs, ears, anus, vagina and more rarely, the
mouth (Hall and Wall, 1995). The aim of this papers is to
report an extensive case of myiasis in the reconstruction flap.
CASE REPORT
A 53 year old male patient, alcohol dependent, was reported to
our hospital with a chief complain of overgrowth over the right
side buccal aspect of the lower jaw extending from 2nd
premolar to the angle of the mouth which was ulcer
proliferative in nature(Fig 1 & 2). According to the protocol
routine blood investigations and radiographic investigations
were done.
*Corresponding author: Dr. Wasim Pathan,
Bharati Vidyapeeth Dental College and Hospital, Pune, India.
histopathologically reports a well differentiated squamous cell
carcinoma. Taken into consideration hemimandibulectomy
with PMMC flap reconstruction with a 3 dimensional recon
plate was planned treatment and executed accordingly (Fig 3).
After the surgery the case follow up was lost due to patients
negligence, and nearly about 1 month post surgery patien patient
reported back with dehiscence and plate exposure (Fig 4). Due
to the exposure of the plate, there was secondary infection in
the same area, hence, plate removal was carried out under local
anaesthesia. After removal of the plate, patient again failed to
maintain oral hygiene. On a close look we could notice the
larvae growing in the necrosed flap in the reconstructed region
(Fig 5). The treatment is a mechanical retrieval of the maggots
that were irritated one by one with turpentine oil and glycerine
mixture over the necrosed flap (Fig 6).
DISCUSSION
Myiasis occurs by dipterous larvae developing in decaying
tissues and the developmental transition via the larval stage
requires an intermidiate host and the number of developing
mber of viable eggs deposited (4). The
larvae depends on the number
late diagnosis and the number of maggots in this report,
determines an extensive tissue damage damage. The myiasis is
diagnosed clinically based on presence of the maggots (Gomez
et al., 2003; Bhatt, 2000; Al- Ismaily and Scully, 1995) but the
classification of the larvae rarely has been made.
68579 Dr. Wasim Pathan et al. Maggots: A doom and bloom in countries with poor oral hygiene
Fig. 1. Preoperative facial photograph
Fig. 2.
Fig. 3. Nec dissection with PMMC with 3D recon plate
Fig. 4. Dehiscence and plate exposure seen 1 month post operative
Fig. 5. Flap failure due to poor hygiene
Fig. 6. Post operative healing after 3 month
Fig. 7. Larvae that was noticed 2 months post operative
Recently a systemic treatment with Ivermectin, a semi-
synthetic macrolide antibiotic, have been used for treatment for
oral myiasis (Shinohara et al., 2004). Oral infections caused by
flies are rare. Such cases are mainly encountered in endemic
areas; however, oral physicians in the developed part of the
world might encounter these cases, especially in immigrants
68580 International Journal of Current Research, Vol. 10, Issue, 04, pp. 68578-68580, April, 2018
and travelers returning from endemic areas. The diagnosis of
oral myiasis is usually clinically alone. Surgical removal is the
preferred treatment of oral myiasis.
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