Anatomy class and ascaris

While preparing a routine sagittal section of the human head and neck for the teaching of anatomy, 3 mature Ascaris lumbricoides worms were seen in the maxillary sinus and 3 in the sphenoidal sinus. Of the worms in the maxillary sinus, 2 were males and one was female, while in the sphenoidal sinus all 3 worms were females. The worms measured 7 - 11 cm in length Light microscope examination of the maxillary sinus wall revealed a few eggs of the parasite in close relation to the epithelium. The migratory abilities of A. Lumbricoides adult worms are well documented and most often involve the bile and pancreatic ducts (Asrat & Rogers, 1995). In a endemic area of Kashmir, India, A. Lumbricoides was the cause of acute pancreatis in 23 percent of 256 patients (Khuroo et al., 1992). Worm extraction and biliary drainage were indicated in 32 percent of 156 patients who had acute hepatobiliary and pancreatic ascariasis, and this resulted in rapid relief of symptoms in most patients (Khuroo et al., 1993). In the case represented, the ostia of the sinuses were between 3 and 4 mm in width and were therefore large enough for the passage of the worms as adults. We are not aware of any other report of ectopic ascariasis involving the sinuses. Clinical data on the current case were not available to us. A. Lumbricoides has high fecundity and the fact that only a few eggs were seen in the sinuses suggests that the worms were immature or that there was a reduction in egg production due to overcrowding or lack of adequate nutrition.(AU).


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