Kurup Lekshmy R, Singh Harshita, Sharma Shilpee Bhatia, Janakiram Trichy Narayanan
Royal Pearl Hospital, Trichy, Tamil Nadu India.
Indian J Otolaryngol Head Neck Surg. 2024 Feb;76(1):298-308. doi: 10.1007/s12070-023-04151-z. Epub 2023 Aug 29.
To propose a surgical staging system with management protocol for post-covid Rhino-orbito-cerebral mucormycosis (ROCM) with central skull base osteomyelitis. A prospective cohort study of a total of 193 post-covid ROCM patients was conducted between May 2021 and January 2022 at a tertiary care centre. Patients were assessed radiologically and staged from I to V. Follow up period was 16 months and the surgical outcome in terms of recurrent disease was assessed. A total of 193 patients (129 primary and 64 revision) were studied. Maxilla was found to be the epicenter of anterior disease (69.3%) and pterygoid wedge was noted to be the epicenter of posterior disease (85.6%). More than 65% of our patients, at the time of presentation, presented with involvement of the central skull base. Intracranial disease was noted in 13.9% of patients and the mortality rate was 6.2%. This staging system provides a systematic step-by-step protocol for the management of ROCM, with emphasis on meticulous disease clearance at the central skull base.
提出一种针对伴有中央颅底骨髓炎的新冠后鼻眶脑型毛霉菌病（ROCM）的手术分期系统及管理方案。2021年5月至2022年1月期间，在一家三级医疗中心对总共193例新冠后ROCM患者进行了一项前瞻性队列研究。对患者进行放射学评估并从I期到V期进行分期。随访期为16个月，并评估了复发性疾病方面的手术结果。共研究了193例患者（129例初次手术和64例翻修手术）。发现上颌骨是前部疾病的中心部位（69.3%），翼状楔被认为是后部疾病的中心部位（85.6%）。超过65%的患者在就诊时出现中央颅底受累。13.9%的患者出现颅内疾病，死亡率为6.2%。该分期系统为ROCM的管理提供了一个系统的逐步方案，强调在中央颅底进行细致的病灶清除。
