Treatment outcome of rhino-orbital-cerebral mucormycosis patients: a retrospective institutional study

Abstract

Introduction Rhino-orbital-cerebral mucormycosis is an acute fungal infection characterized by fungal hyphal invasion of blood vessels resulting in thrombosis and infarction of the nasal, paranasal sinus, orbital, and cerebral tissues. Patients and methods This was a retrospective study conducted on 80 patients with biopsy-proven mucormycosis. The study was carried out in the Mucormycosis Ward of a Tertiary Care Medical College and Hospital during a period of 6 months from May 2021 to October 2021. Results Among 80 patients, 50 (62.5%) were males and 37 (37.5. %) were females. Of the patients, 53.75% were in the age group of 51–70 years. Primary clinical presentation was facial pain/swelling/paresthesia in 75 (93.75%) followed by nasal obstruction in 50 (62.5%) patients and orbital symptoms – pain/edema/blurring of vision in 46 (57.5%) patients. Forty-six patients were known cases of diabetes mellitus and 42 patients had a previous history of coronavirus disease 2019 infection-associated comorbidities. As per staging of the disease, 36 patients were of stage III (involvement of the orbit), 22 patients of stage-II (involvement of paranasal sinuses), 16 patients of stage IV (involvement of central nervous system), and six patients were in stage-I (involvement of nasal mucosa). Forty patients were treated by the modified Denker’s procedure, 30 patients by endoscopic debridement, eight patients by the modified Denker’s procedure with orbital exenteration, one patient by the modified Denker’s procedure with inferior maxillectomy, and one patient by total maxillectomy. All the patients were also given amphotericin injection. Out of 80 patients, 64 patients survived with sequelae, while 16 patients expired till date.