The Ear
Aural Myiasis.—While the larva of Chrysomyia macellaria, known as the “screw worm,” is the one most frequently reported from the external auditory canal, yet many such cases have been connected with the larvae of Sarcophaga carnaria, Calliphora vomitoria and Anthomyia pluvialis. These larvae are usually deposited in the auditory canals of those with otorrhoea.
The symptoms are intense earache, giddiness and possibly convulsions. The larvae tend to perforate the tympanic membrane. Instillations of 10% chloroform in milk or the use of oils kill the larvae.
In the stuporous states of plague and typhus fever there often appears to be a state of deafness.
One must always keep in mind the ringing of the ears indicative of the physiological action of quinine. Permanent deafness may be produced by the long continued use of quinine.
In leprosy the lobes of the ears are special sites of preference for the nodules and I always palpate the lobes where the nodules are not distinctly visible.
The Nose
Nasal Myiasis.—In cases of ozaena certain flies appear to be attracted and to deposit their eggs at the nasal orifices. The larvae developing from the eggs of Chrysomyia macellaria, a fly common in tropical America, are known as “screw-worms” and cause frightful destruction of the nasal structures.
They may bore into the adjacent sinuses. Marked frontal headache and a purulent or bloody discharge are symptoms. Great swelling of the nasal structures precedes the destruction of the cartilaginous and bony tissues.
Leprosy.—The nasal mucosa is apt to be the seat of leprous nodules. Those located on the septum may ulcerate and material from these ulcers show abundant leprosy bacilli. Alternations of dryness and hypersecretion of the Schneiderian membrane are among the early manifestations of the disease.