Abstract
Objective
To explore a method for removing a living leech from the nasal cavity.
Materials and methods
A total of 5 patients with nasal leech were examined. Nasal endoscopy revealed the presence of a wriggling leech in the nasal cavities of each of these patients. A negative suction tube with an inner diameter of 3 mm and a negative pressure of 30–40 kp was used to remove these leeches. In each case, this suction tube was aimed at the free end of the leech, and the leech was gradually and slowly sucked into the tube. The suckers of the removed leeches were examined to ensure that no leech fragments remained within each patient.
Results
In all 5 cases, the intact leech was successfully removed. No surgical complications occurred.
Conclusions
The negative suction method can successfully remove nasal leeches.
1
Introduction
Reports have described the discovery of leeches as foreign bodies in various regions of the upper respiratory tract, including the nasal cavity , nasopharynx , oropharynx , hypopharynx , and throat . Leech infestation is most common among children and elderly individuals. In the past, forceps have frequently been utilized to remove leeches in the upper respiratory tract . However, because leeches are soft and slimy, they may evade capture by forceps or may fragment when grasped with forceps . In the present study, we introduce a negative suction method that can be used to remove foreign bodies from the upper respiratory tract.
2
Materials and methods
The institutional review boards at the Affiliated Second Hospital of Sun Yat-sen University approved this study. The 5 examined patients (1 male patient, 4 female) aged 5, 7, 72, 78 and 83 years, and the durations of their conditions ranged from 4 days to 25 days. A total of 4 patients had used their hands to drink mountain stream water and washed their faces with this water, whereas the remaining patient had swum in mountain stream water.
All patients presented with epistaxis and nasal itching. These patients experienced repeated episodes of epistaxis. Each of these episodes was self-limiting, involved a small quantity of blood, and was accompanied by the sensation of a foreign body in the nasal cavity.
A nasal endoscopic examination revealed the presence of a leech in the nasal cavity of patients. A leech was found in the middle section of the nasal septum in 2 patients, in the middle nasal meatus in 2 patients, and in the superior nasal meatus in 1 patient. These leeches were beige in color and wriggled within the patients’ nasal cavities. There were bloodstains on the surfaces of nasal septal and middle turbinate regions that had been invaded by a parasitic leech. Pallor was evident in the mucous membranes of nasal septal and middle turbinate regions that were in contact with a leech. In addition, 1 patient had a low hemoglobin count.
2.1
Treatment
A solution of 1% tetracaine was sprayed into the nasal cavity to reduce mucous membrane sensitivity and leech activity; 1% ephedrine was sprayed into the nose to induce the contraction of the nasal cavity. Wriggling leeches were discovered by endoscopic examinations ( Fig. 1 ). A negative suction tube with an inner diameter of 3 mm and a negative pressure of 30–40 kp was used for leech removal. In particular, this tube was aimed at the free end of each leech, causing the leech to be slowly sucked into the tube ( Figs. 2, 3 ). The suckers of the removed leeches were examined to ensure that no leech fragments remained within each patient ( Fig. 4 ). All leeches removed in this study were intact. Ciprofloxacin was administered to prevent bacterial infection by Aeromonas hydrophila .
2
Materials and methods
The institutional review boards at the Affiliated Second Hospital of Sun Yat-sen University approved this study. The 5 examined patients (1 male patient, 4 female) aged 5, 7, 72, 78 and 83 years, and the durations of their conditions ranged from 4 days to 25 days. A total of 4 patients had used their hands to drink mountain stream water and washed their faces with this water, whereas the remaining patient had swum in mountain stream water.
All patients presented with epistaxis and nasal itching. These patients experienced repeated episodes of epistaxis. Each of these episodes was self-limiting, involved a small quantity of blood, and was accompanied by the sensation of a foreign body in the nasal cavity.
A nasal endoscopic examination revealed the presence of a leech in the nasal cavity of patients. A leech was found in the middle section of the nasal septum in 2 patients, in the middle nasal meatus in 2 patients, and in the superior nasal meatus in 1 patient. These leeches were beige in color and wriggled within the patients’ nasal cavities. There were bloodstains on the surfaces of nasal septal and middle turbinate regions that had been invaded by a parasitic leech. Pallor was evident in the mucous membranes of nasal septal and middle turbinate regions that were in contact with a leech. In addition, 1 patient had a low hemoglobin count.
2.1
Treatment
A solution of 1% tetracaine was sprayed into the nasal cavity to reduce mucous membrane sensitivity and leech activity; 1% ephedrine was sprayed into the nose to induce the contraction of the nasal cavity. Wriggling leeches were discovered by endoscopic examinations ( Fig. 1 ). A negative suction tube with an inner diameter of 3 mm and a negative pressure of 30–40 kp was used for leech removal. In particular, this tube was aimed at the free end of each leech, causing the leech to be slowly sucked into the tube ( Figs. 2, 3 ). The suckers of the removed leeches were examined to ensure that no leech fragments remained within each patient ( Fig. 4 ). All leeches removed in this study were intact. Ciprofloxacin was administered to prevent bacterial infection by Aeromonas hydrophila .
