Surgeons prevented 50 maggots from burrowing into an Indian man’s face by extricating the flesh-eating creatures from deep inside his sinuses, The Independent reported.

Doctors believe that nasal myasis— when larvae or flies infest the nose and sinuses —occurred when a fly laid its eggs in or around the man’s nose, which then hatched into maggots.

Each maggot measured less than half an inch long and, if left as they were, would have chewed into and destroyed the bones and soft tissues of the man’s face, nose and eyes. Without the surgery, the 55-year-old man also could have developed meningitis or blindness, or even died.

Nasal myasis is common in tropical countries— especially among people who are alcoholics, or maintain poor hygiene or nutrition. Symptoms include irritation, sneezing, tears and headaches, as well as puffy eyes and watery blood-stained discharge from the nose, according to The Independent.

Surgeon Dr. Meenesh Juvekar, who performed the two-hour procedure, uploaded a video to YouTube that shows the maggots tightly packed into the man’s nasal cavities. After he removes the insects, they can be seen wriggling around in a metal bowl before Juvekar disposes them.

Juvekar said he had only seen six to eight cases of nasal maggots in 15 ears during his practice.

The patient in the video, who was not named, is expected to make a full recovery.

Surgery is only necessary in severe cases of nasal myasis. Maggots can typically be killed using chloroform water and oil. Doctors can then use saline water to flush out the dead insects.

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