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VOLUME 16 , ISSUE 3 ( September-December, 2024 ) > List of Articles

CASE SERIES

Management of COVID-19-associated Rhino-orbital Mucormycosis and Reconstructive Options for the Resulting Extensive Defects: A Case Series and Brief Review of the Literature

Sujeeth Shetty, Varun Shukla

Keywords : Case Series, COVID-19, Mucormycosis, Prosthetic rehabilitation, Reconstructive surgery

Citation Information : Shetty S, Shukla V. Management of COVID-19-associated Rhino-orbital Mucormycosis and Reconstructive Options for the Resulting Extensive Defects: A Case Series and Brief Review of the Literature. Int J Otorhinolaryngol Clin 2024; 16 (3):146-150.

DOI: 10.5005/jp-journals-10003-1483

License: CC BY-NC 4.0

Published Online: 10-04-2025

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Background: Rhino-orbital mucormycosis is an uncommon and grave fungal infection which has shown an increasing trend since the advent of COVID-19. Case description: Our facility treated three patients with rhino-orbital mucormycosis linked to COVID-19. CT-PNS and MRI brain with orbits was performed to ascertain the extent of involvement. Direct nasal endoscopy and biopsy confirmed the diagnosis of mucormycosis. Aggressive surgical debridement by bilateral maxillectomy along with prompt medical therapy was indicated. Discussion: A timely diagnosis, elimination of risk factors, surgical debridement, and rapid antifungal therapy are all imperative for effective mucormycosis treatment. The procedure was well tolerated by all the patients. Post-op follow-up for up to 6 months showed satisfactory healing. The surgical procedures often result in severe debilitating and disfiguring defects. Conclusion: The overall prognosis depends on the rapid diagnosis and treatment, and the patient's underlying conditions. Rehabilitation options range from prostheses to various flap surgeries. Clinical significance: Mucormycosis is an evolving disease. Patients with diabetes mellitus, injudicious corticosteroid use, along with COVID-19 appears to be at an unholy trifecta and make the patients prone to mucormycosis. All necessary measures must be taken to sustain optimum glucose levels and at most cautious utilization of systemic steroids in COVID-19 patients. The diagnosis of mucormycosis continues to be arduous, with histopathological, clinical examination, and culture being the cornerstone. The combination of aggressive surgical debridement and antifungal drugs is considered an ideal treatment for the condition. Patients of rhino-cerebral mucormycosis with resultant tissue defects in the maxillofacial region can be sufficiently reconstructed and rehabilitated using a multitude of options.


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