Raghani Manish J, Preetha Anand P, Galhotra Virat
Head of Department of Dentistry, All India Institute of Medical Sciences, Raipur, India.
J Maxillofac Oral Surg. 2024 Dec;23(6):1455-1461. doi: 10.1007/s12663-024-02129-0. Epub 2024 Mar 10.
Mucormycosis is an aggressive, life-threatening infection that requires prompt diagnosis and early treatment. Depending on the severity of the disease, rhinomaxillary mucormycosis (RMM) may necessitate maxillectomy, ranging from partial to total removal. The implementation of primary closure leads to improved functional ability by creating a separation between the oral and nasal cavities, which facilitates oral intake and reduces the duration of nasogastric feeding. This, in turn, enhances the patients' quality of life. The objective of this study was to evaluate the effectiveness of primary closure using palatal mucosa (PM) following maxillectomy in patients with RMM.
We conducted a retroprospective study to analyze the outcomes of 32 operated cases of rhinomaxillary mucormycosis (RMM). After maxillectomy, we preserved highly vascular uninfected palatal mucosa to close the maxillary defect. The study spanned 4 months, encompassing 4 months of retrospective data collection and 3 months of prospective data collection.
During the 3rd month follow-up, complete closure and uptake of the flap were observed in 22 patients. At the 6-month follow-up, 28 participants exhibited total uptake of PM, with no oro-antral/nasal communication.
This study concludes that in most circumstances, employing a PM flap to close the defect after maxillectomy and surgical debridement is a successful approach as it reduces the occurrence of oro-antral/oro-nasal communication.
毛霉菌病是一种侵袭性、危及生命的感染,需要及时诊断和早期治疗。根据疾病的严重程度,鼻上颌毛霉菌病(RMM)可能需要进行上颌骨切除术,范围从部分切除到全部切除。一期缝合通过在口腔和鼻腔之间形成分隔来改善功能,这有助于经口进食并缩短鼻饲时间。反过来,这提高了患者的生活质量。本研究的目的是评估在RMM患者上颌骨切除术后使用腭黏膜(PM)进行一期缝合的有效性。
我们进行了一项回顾性前瞻性研究,以分析32例接受手术治疗的鼻上颌毛霉菌病(RMM)病例的结果。上颌骨切除术后,我们保留血管丰富的未感染腭黏膜以封闭上颌骨缺损。该研究为期4个月,包括4个月的回顾性数据收集和3个月的前瞻性数据收集。
在第3个月随访时,22例患者观察到皮瓣完全闭合和成活。在6个月随访时,28名参与者的PM完全成活,无口鼻/鼻窦相通。
本研究得出结论,在大多数情况下,上颌骨切除术后和手术清创后使用PM皮瓣封闭缺损是一种成功的方法,因为它减少了口鼻/鼻窦相通的发生。