Myiasis is the infestation of tissues and organs of animals and humans caused by the larvae of certain dipteran flies. It is more common in undeveloped and tropical countries and usually affects elderly patients, persons who are sick, and patients with mental illness. Oral myiasis is a rare pathologic condition and a risk to the patient's life because of its great destructive potential. Therefore, appropriate treatment is necessary. This article aimed to report a case of myiasis caused by Cochliomyia hominivorax in the palate of a patient with primary progressive aphasia, which was successfully treated through mechanical removal of larvae plus administration of ivermectin.

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increasing vascularization and osteoclast activity, which results in bone absorption. 4 Infection may be a possible cause of skull thinning because it can increase osteoclastic activity. 5 However, the patient in this case showed no signs of infection as evidenced by both laboratory tests and MRI images.Among these possibilities, the thinned skull as a result of the grinding injury was absorbed in the inner table, whereas the apposition was decreased on the outer cortex as the cranial vault expanded. The latter is thought to have played the most important role in creating the skull defect in this case. This process occurred naturally and the patient did not complain of any neurological symptoms, such as headache or tenderness. The indications for skull defect coverage are affected by the surrounding soft tissue, the presence of infection, and the underlying structure. 6 Therefore, after consulting with the neurosurgery department it was decided that surgery to reconstruct the defect was not required. CONCLUSIONThe reconstruction of scalp injuries in pediatric patients is especially difficult to manage because of the limited available donor site and the potential skull growth. Normally, rapid wound healing response in a young patient is a favorable factor in treatment. However, the active bone modeling process of a child can induce bone absorption, which can be seen as an osteolytic lesion when observed using radiological studies. We aimed to share the case of scalp reconstruction using a free LD flap coverage in a pediatric patient who experienced delayed thinning of calvarial bone as the patient aged.