Management of Malignant Wound Myiasis in Advanced Head‑and‑Neck Cancer Patients: A Prospective Observational Study.

Abstract

Our findings highlight the significance of regularly assessing wounds and related symptoms in patients with head and neck cancer. This study found that systemic treatment with anti-helmenthic such as Ivermectin and Albendazole combined with broad spectrum antibiotics and turpentine oil dressing helps in removal of maggots, early recovery, ease of agony, and other related symptoms. However, more comprehensive studies are required to demonstrate the efficient management of malignant wound myiasis. 10 patients with advanced head and neck cancer presented with maggots either from wound site, scalp, oral cavity or nostril, with ECOG score 3 or less were enrolled in this study. Symptoms were assessed using Edmonton Symptom Assessment Scale (ESAS) and Wound was assessed by Wound Assessment Tool, at baseline and then at days 1, 3, 5, and 7. Tab Albendazole 400 mg once daily, turpentine oil for dressing three times daily for five days, Tab Ivermectin 12 mg and Broad-Spectrum Antibiotics- Tab Amoxicillin + Potassium Clavulanate and Tab Metronidazole twice a day were given to all patients for five days. We found significant improvement in scores of wound and all other related symptoms on days 1, 3, 5 & 7, except for bleeding, edema, nausea, anxiety, appetite loss and feeling of well-being, which remained same on Day 1, but improved afterward. Side effects were self-limiting. Systemic treatment with Anti helminthic- Ivermectin, Albendazole, Broad spectrum antibiotics, and turpentine oil enhances the removal of maggots, early recovery and relief from distress and associated symptoms.