Prognostication of Sino-Nasal Mucormycosis

Iran J Otorhinolaryngol. 2022 Jul;34(123):157-164. doi: 10.22038/IJORL.2022.58523.3021.

Abstract

Introduction: For the purpose of prognostication of sinonasal mucormycosis, a detailed analysis of the clinical, diagnostic, therapeutic and outcome parameters has been contemplated.

Materials and methods: Retrospectively data was collected for all patients of sinonasal mucormycosis managed in a tertiary care hospital in last 5years.

Results: Diabetes was the commonest comorbidity among total of 52 cases. Disease extent-wise, 16, 23 and 13 patients had sino-nasal (SN), rhino-orbital (RO) and rhino-orbito-cerebral (ROC) mucormycosis respectively. Median cumulative Amphotericin-B administered was 3.5gms and 94.2% of cases underwent surgical debridement depending on the disease extent. With a median follow-up of 18months, 67% of the patients are alive and disease free, 2% are under treatment and 29% of patients have expired. The mortality rate was 12.5% in SN, 30.5% in RO and 38.5% in ROC mucormycosis. Palatal and orbital involvement is associated with statistically significant mortality risk at one month.

Conclusions: Mortality rate in sino-nasal mucormycosis can be significantly curtailed with prompt control of underlying comorbidity, aggressive medical and adequate surgical management.

Keywords: Amphotericin; Diabetes; Mucormycosis; Orbital mucormycosis; Sino nasal Mucormycosis.