Aural myiasis caused by cochliomyia hominivorax: case report

This is a case of aural human myiasis caused by Cochliomyia hominivorax, a rare etiologic insect in Belize, Central America. A definite diagnosis was made by identifying the larvae, which were removed and sent for identification. Perforation of the drum, and migration of the larvae to the middle ear and mastoid cavity developed in this case within 48 hours. The larvae were removed from the infested regions surgically. Myringoplasty was performed and the patients hearing restored (AU)

Auditory and ophthalmic survey results in a Jamaican suburban population

A survey of ophthalmological aural and neurolgical disease was carried out among adults age 35-74 years in August Town, a suburban community in Kingston, Jamaica. A private census showed a total population of this age group of 676. 576 (85.2 per cent) were examined ophthalmologically and 551 (81.5 per cent) audiometrically. Ophthalmic Survey: The analysis is not yet complete but provisional inspection of the results shows: (1) Pterygia was common (16 per cent) and more prevalent among those of lighter complexion, suggesting a racial difference in susceptibility. (2) The prevalence of progressive cataracts varied from 3 per cent in 35-44 age group to 75 per cent in those over 65. Cataracts were commoner in diabetics than in non-diabetics. (3) Chronic simple glaucoma as defined by raised intra-ocular pressure, typical field detects and cupping of the discs was found in four new cases. The prevalence was greater than that found in a Welsh survey but the numbers are too few for definite conclusions on relative prevalence to be reached. (4) The triad of poor visual acuity of unknown cause, field defects and pallor of the discs was found in eight patients, five of whom also had sensorineural deafness and three of whom had signs suggestive of the ataxic form of 'Jamaican neuropathy'. (5) The following cases were seen: anterior uveitis - 3, posterior uveitis - 10, diabetic retinopathy - 10, hypertensive (grade ii) - 9, hypertensive, (grade iii) - 2, senile macular degeneration - 4, myopic degeneration - 2. Audiometric survey: Conductive deafness was found in 1 per cent of the ears, compared with 6 per cent in a Scottish survey. After elimination conductive deafness, mean hearing thresholds, particular at high frequencies, were better in Jamaicans than in Scots. Jamaican men had lower thresholds (i.e. hearing better) than women whereas the reverse was found in Scotland. Sensorineural deafness (mean hearing threshold 30 or more above normal at the conversational frequencies of 500, 1,000 and 2,000 c/s) was found in one or both ears of 11 per cent of women and 5 per cent of men. The aetiology of this deafness is obscure although a proportion higher than would be expected had signs associated with "Jamaican neuropathy". No cases of deaf-mutism, Menieres syndrome or neuro-fibroma of the eight nerve were seen. One case of oto-sclerosis was diagnosed (AU)