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Objective : To develop a systematic approach for magnetic resonance imaging (MRI) analysis, imaging spectrum, and classification system for the staging of post-COVID-19 head and neck mucormycosis. Method : The study included 63 post-COVID-19 patients with pathologically proven mucormycosis who underwent head and neck MR imaging. Three independent radiologists assessed the imaging spectrum of mucormycosis, MRI characteristics of sino-nasal mucormycosis, and extra-sinus extension, and submitted a final staging using a systematic approach and a proposed categorization system. A consensus reading was considered the reference imaging standard. The kappa statistics were used to assess the categorization system's diagnostic reliability. Results : The overall interreader agreement of the MR staging system was very good (k-score= 0.817). MR imaging spectrum involved localized sino-nasal mucormycosis (n=7 patients, 11.1%), sino-nasal mucormycosis with maxillo-facial soft tissue extension (n=28 patients, 44.5 %), sino-nasal mucormycosis with maxillo-facial bony extension (n=7 patients, 11.1%), sino-naso-orbital mucormycosis (n=13 patients, 20.6%), and sino-nasal mucormycosis with cranium or intracranial extension (n= 8 patients, 12.7%). Extra-sinus extension to the orbit and brain did not have significant association with involvement of the posterior ethmoid/sphenoid sinuses and maxillo-facial regions ( P >0.05). MRI-based staging involved four stages: stage 1 (n=7, 11.1%); stage 2 (n=35, 55.6%), and stage 3 (n=13, 20.6%), and stage 4 (n=8, 12.7%). Involvement of the bone and MR-based staging were significant predictors of patients’ mortality P=0.012 and 0.033 , respectively. Conclusions : This study used a diagnostic-reliable staging method to define the imaging spectrum of post-COVID-19 head and neck mucormycosis and identify risk variables for extra-sinus extension.

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Background: High-resolution computed tomography (HRCT) magnifies the role of preoperative imaging for detailed middle ear anatomy particularly its hidden area. The purpose of the current study was to assess the sinus tympani (ST) and supratubal recess (STR) by HRCT, to create CT classification of the STR depth, and to study the relationship between ST types and the new STR grades. Results: In HRCT of non-pathological temporal bones of 100 subjects (200 ears), measurements of the STR and ST were calculated, registered, and analyzed. The depth of the STR was classified into grade 1 with depth less than 3 mm, grade 2 with depth ranged between 3 and 5 mm, and grade 3 with depth more than 5 mm. The mean STR length, width, and height were 4.17 ± 0.86, 3.55 ± 0.65, and 3.64 ± 0.7 mm, respectively, while the ST mean length and width of were 2.52 ± 0.5 and 1.82 ± 0.78 mm, respectively, without significant differences between either sexes or sided. The ST types were found to be type A in 56 ears (28%), type B in 142 ears (71%), and type C in 2 ears (1%). The STR grading was grade 1 in 12 ears (6%), grade 2 in 160 ears (80%), and grade 3 in 28 ears (14%) without significant relationship between ST types and STR grading (P = 0.3). Conclusion: The current study provided reliable and applicable methods of CT assessment of STR and ST that can help to predict the degree of surgical visibility of the ST and STR during ear surgery.

Objective Assessment the effect of topical application of mitomycin‐C (MMC) after endoscopic removal of antrochoanal polyp (ACP) on its recurrence rate. Methods This prospective study was done on patients with ACP. Endoscopic nasal surgery has been done to remove the polyp after wide middle meatal antrostomy. The patients were categorized into two groups. In MMC group, after endoscopic ACP removal, MMC on a piece of cotton was topically applied inside the maxillary antrum in the suspected site of ACP origin. A second group was used as a control group without MMC application. Results The study included on 40 patients; 20 patients in each group. Topical MMA application was easily performed. No granulation, crust, infection, or bleeding was reported in all cases of both groups. Recurrent polyp was not reported in MMC group, while recurrent polyp was detected in four cases (20%) in control group without MMA application with statistically significant difference (P = .035). Conclusion Topical MMC application inside the maxillary sinus after endoscopic removal of the ACP is safe, easy, and effective. Level of evidence 2c.