Prognostication of Sino-Nasal Mucormycosis

Document Type : Original

Authors

Department of Otolaryngology & Head Neck Surgery, All India Institute of Medical Sciences, New Delhi, India.

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