HOLISTIC STUDY OF FACIAL REHABILITATION OF MUCORMYCOSIS IN PATIENTS INFECTED WITH COVID- 19

Abstract

Background: Mucormycosis is a deep fungal infection which witnessed a steep rise in India following the covid 19 pandemic. Extensive involvement with sinonasal and sinonasocerebral variants were seen. Involvement of various structures of sinus orbit and nose along with soft tissues put the patients into threat of losing the supporting and covering structures for survival. Post debridement there was composite defects of face. Addressing these disgurement and planning a suitable reconstruction based on there general health condition with multiple comorbidities is a challenge. this study aims at evaluating the factors associated with poor outcome in ap reconstruc Aim: tion and selection of the types of aps , timing of reconstruction and type of reconstruction associated with favourable outcome. Material And Methods: Prospective observational study conducted from Apr 2021 to Apr 2022 of 20 patients for reconstruction of post mucormycosis debridement facial defects. The factors like d- dimer, ferritin, LDH, timing of surgery, type of reconstruction, types of aps and the condition of the debrided residual tissues were assessed for its association with the ap outcome. Follow up at regular intervals were done to look for complications upto 6 months. Out of 20 patients, 13 Results: had good clinical outcome for aps in terms of its survival, lack of dehiscence, but still had functional decit. Whereas, 7 patients had complications of aps like ap failure, ap dehiscence and underwent secondary surgery. All these patients had increased comorbidities, increase in the acute phase proteins suggesting the persistence of inammatory state post covid. Best outcome in Conclusion: facial rehabilitation in post mucormycosis defects can be brought by optimizing the risk factors, deciding on the time of intervention, giving enough time for the residual tissue to improve and the acute phase proteins to normalize and selection of suitable aps for reconstruction.