INTRANASAL LEECH (HIRUDINIASIS) COMMON MODE OF PRESENTATION AND SITES OF LODGMENT

Abstract

Objective: To assess the common mode of presentation and sites of lodgment in cases of nasal leech infestation.
Design: Descriptive study.
Place and Duration of Study: This study was conducted in the ENT Department of Shaikh Khalifa Bin Zayed Al Nahyan Hospital (CMH) Muzaffarabad from 10th Jan 2010 to 15th Feb 2012.
Patients and Methods: After getting informed consent, total of 70 cases that fulfilled the inclusion criteria i.e patients irrespective of age and gender with a positive history of epistaxis and use of spring water for daily utilities and especially after exclusion of other known causes for epistaxis were included in this study. A thorough history followed by ENT examination including nasal endoscopy was carried out in each case and site of lodgment of leech documented. This was followed by removal of leech from nose.
Results: The commonest mode of presentation of nasal leech was epistaxis (54.28%) and the commonest site of lodgment of leech was under the inferior turbinate (inferior meatus) (82.86%).
Conclusion: This rare cause of epistaxis should be kept in mind once all other common causes are excluded especially if the patient belongs to low socioeconomic group and using fresh spring water for their consumption. A thorough search in the region of inferior meatus should be under taken aided by nasal endoscope if available.