European Journal of Molecular & Clinical Medicine

Abstract

Background:Mucormycosis has been increasingly described in patients with covid 19
2nd wave (delta variant) which is a highly contagious disease caused by SARS-COV-2 is
the leading cause of global pandemic. AIM AND OBJECTIVES: To evaluate etiology,
indications, management options and complications in patients managed with
endoscopic and external maxillectomy after mucormycosis, to evaluate the incidence
and distribution of cases who had extensive mucormycosis and to evaluate the outcome
of the management options.
Materials and Methods: This is a prospective study done in 30 cases at a tertiary care
centre.All the patients were subjected to detailed history taking, clinical
examination,endoscopic,radiological,pathological,microbiological investigations after
taking informed consent. Patients with age group(30yrs -70yrs) who presented with
ROM with extensive maxillary sinus involvement and destruction of different walls of
the maxillary sinus were managed with different types of maxillectomies.
Results: In this study, 30 cases of post covid rhinoorbital mucormycosis who presented
to our hospital were studied,among male 24(80%) & females6 (20%).12 patients (40%)
were in 5th to 6th decade and 9 patients (30%) in 4th to 5th decade.Main presenting
features were unilateral cheek pain,cheek swelling,nasal obstruction,loosening of teeth,
tooth ache, cheek numbness, headache,periorbital edema,visual disturbances being
present in 95% of the patients.5% presented with epistaxis,ptosis,diplopia alone.90%
patients were known case of diabetes milletus,10% are denovo diabetes.All the patients
were subjected to routine blood investigations, microbiological,
radiologicalinvestigations.(CT,MRI contrast- PNS,Orbit & Brain).Most commonly seen
in males 80%. 1 patient had to undergo orbital exenteration,3 patients underwent
palatal resection.
Conclusion: Debridement of sinuses is necessary in all cases of mucormycosis so that the
fungal reservoir could be removed and the antifungal therapy can reach the viable
areas. Therefore the management of mucormycosis is individualised to each patient
based on the extension of the disease and overall general conditon of the patient