Functional Endoscopic Sinus Surgery and Recurrence of Post-COVID Mucormycosis

• Published in: Journal of maxillofacial and oral surgery Vol. 23; no. 5; pp. 1316 - 1323
• Main Authors: Rudagi, B. M., Goyal, Jay, Palande, Chinmayee, Patil, Prachi
• Format: Journal Article
• Language: English
• Published: New Delhi Springer India 11.10.2022; Springer Nature B.V
• Subjects: Asymptomatic; Clinical Paper; Consent; Coronaviruses; COVID-19; Dentistry; Diabetes; Edema; Endoscopy; Fungal infections; Fungi; Headaches; Medicine; Medicine & Public Health; Oral and Maxillofacial Surgery; Otolaryngology; Otorhinolaryngology; Pandemics; Plastic Surgery; Pneumonia; Respiratory diseases; Sinuses; Surgery; Teeth; Viruses; Functional endoscopic sinus surgery (FESS); Orbital exenteration; Post-COVID mucormycosis; Ethmoidectomy; Maxillectomy
• ISSN: 0972-8279; 0974-942X
• DOI: 10.1007/s12663-022-01810-6

Purpose To evaluate the value and limitation of functional endoscopic sinus surgery alone for the management of post-COVID mucormycosis and need for adjunctive invasive procedure. Materials and Methods This is a clinical observational study that included a total of 17 patients who underwent FESS for post-COVID mucormycosis from April 2021 to May 2021. These patients reported to our institute with no improvement in their symptoms post-FESS from June 2021 to July 2021. Aggressive Surgical debridement of the involved sinuses, removal of surrounding necrotic bone and orbital exenteration (wherever necessary) was done in these patients. A regular follow-up till six months was done for every patient. Sixteen out of 17 patients did not report with any fresh complaint or recurrence. Results The study included male and female in ratio of 12:5, with a mean age of 62.5 ± 7.7 years (range: 50–75 years). These patients underwent functional endoscopic sinus surgery, one to two months before reporting to our institute. Post-FESS, there was no improvement in the symptoms. All these patients were given systemic antifungal treatment post-operatively. The specimen was sent for histopathological as well as microbiological examination. All the FESS operated patients required a secondary more aggressive surgical intervention. Conclusion Post-COVID mucormycosis is an aggressive fungal infection, for which FESS proves inadequate. It requires an aggressive surgical debridement of the necrotic bone along with the debridement of the sinuses.