A STUDY OF COVID-19 RELATED MUCORMYCOSIS AND ITS SURGICAL MANAGEMENT: OUR EXPERIENCE AT A TERTIARY CARE CENTER

Abstract

Background: Endoscopic sinus surgery [ESS] and its various approaches have become popular for several extended
indications such as recurrent sinusitis and inverted papilloma. ESS is a suitable option for radical debridement in
rhinocerebral mucormycosis.
Aims: The study aims to evaluate the role of trans-nasal endoscopic partial maxillectomy combined with the removal of
devitalized tissues from various sinuses, peri-orbital spaces, infra-temporal fossa, pterygopalatine fossa in patients
diagnosed with Mucormycosis during Covid-19 pandemic.
Methods: This is a hospital-based prospective observational study in which, a total of 93 cases of Mucormycosis were
observed. Trans-nasal endoscopic partial maxillectomy combined with debridement of various sinuses was done.
Results: Covid-19 induced Mucormycosis commonly presented with nasal discharge, epistaxis, hemifacial pain,
hemifacial swelling, proptosis, visual disturbances, and vision loss. A total of 93 patients were observed under this
study out of which 91% were cured and 9% died postoperatively due to Covid-19-related MODS. Standard trans-nasal
endoscopic debridement via a maxillary antrostomy does not suffice for the complete eradication of disease since
access to all parts of the maxillary sinus cannot be achieved by this route.
Conclusion: The study concluded that TEPM can be a valuable surgical approach in the management of Covid-19
induced mucormycosis.