Abstract
Nasal leech infestation is usually through contact with water containing leeches when drinking, face-washing, or swimming. Thus the entry of leeches into the nasal passage can easily go unnoticed. Nasal infestation of leeches results in epistaxis and occasional foreign body sensation. We present five patients with nasal leeches complaining of recurrent epistaxis. Tracing their history, all had either swum in the ponds or drunk untreated fresh water 3 or more weeks ago. In three patients the leeches were removed after lidocaine and ephedrine nasal spray in the outpatient department. The remaining two needed general anesthesia for either endoscopic removal or electric shock of leeches by bipolar cautery before removal. Leeches have three toothed jaws which protrude through their mouth and make a typical Y-shaped wound on skin or mucosa. Their salivary glands secrete a kind of anticoagulant called hirudin, as well as substances which have the effect of vasodilation and anesthesia. When treating epistaxis, a variety of nasal 'foreign bodies' should not be overlooked. Due to the progress in public health and education, nasal leech infestation in Taiwan should have been rare in recent years. However, we found that three of the five cases occurred within the past half year, and most of them had ever played in the water. As the population has adjusted to the 2-day weekends, it has become popular to visit rural areas on the weekends. Thus the incidence of leech infestation may be on the increase. It is necessary to prevent contact with leeches during recreation. Leech infestation can be avoided by drinking only boiled water or at least inspecting the water before swallowing.
Original language | English |
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Pages (from-to) | 332-336 |
Number of pages | 5 |
Journal | Journal of the Otolaryngological Society of the Republic of China |
Volume | 34 |
Issue number | 4 |
State | Published - 1999 |
Externally published | Yes |
Keywords
- Hirudin
- Leech
- Nose