Mucormycosis is almost always confined to the patients with altered host defenses amongst which diabetes is considered as the strongest risk factor. COVID-19 only been seen in severe cases but also in mild and moderate cases of SARS-CoV-2 infections. After preliminary clinical and radiological diagnosis, surgical management in the form of endoscopic sinus surgery, debridement, and orbital exenteration (8) was performed. Medical management in the form of antifungal therapy (amphotericin-B, posaconazole, and isavuconazole) was initiated. In this case series, 79 proven cases of COVID-19 associated rhino-orbital-cerebral mucormycosis were analyzed retrospectively from mid-April 2021 to mid-September 2021. 67 patients were known diabetics, whereas rest 12 had new onset diabetes mellitus. Of these 79 cases, 27 cases had the disease limited to sinuses (rhino-mucormycosis), 43 had orbital involvement also (rhino–orbital mucormycosis), and 9 had cerebral involvement as well (rhino–orbital–cerebral mucormycosis). During this time-period, a total of 14 mortalities occurred. Most of the patients were discharged after completion of amphotericin-B therapy and rest stayed little longer till their general condition improved. COVID-19 causes dysregulation and alteration of immune response in the body which predispose to invasive fungal infections. In addition, uncontrolled diabetes mellitus and corticosteroid treatment increase the risk of mucormycosis by many folds.

This prospective observational study evaluates the role of tympanoplasty type III in cholesteatoma ear disease during same sitting with mastoid surgery using cartilage ossiculoplasty. Forty patients of chronic suppurative otitis media-cholesteatoma disease were recruited in the study. All the patients had extensive cholesteatoma and underwent canal wall down mastoid surgery. Tympanoplasty type III, that is, stapes columella, minor columella, or major columella, was done in each case along with mastoid surgery depending upon the remnant ossicular status. Conchal cartilage graft was used for ossiculoplasty along with temporalis fascia graft. Hearing and graft uptake results were evaluated at the end of 6 months postoperatively. Of the 40 cases, 3 cases failed tympanoplasty. In the remaining 37 cases, a statistically significant hearing improvement (air–bone gap of 33 dB) was observed postoperatively. Seven cases underwent stapes columella, 13 cases underwent minor columella, and 17 cases underwent major columella tympanoplasty type III. Although a hearing improvement was recorded in all these subgroups, a statistically significant hearing gain was present only in tympanoplasty type III minor columella cases thereby underlying the importance of intact stapes. However, it is difficult to discern the type of tympanoplasty type III that the patient would undergo prior to the ear surgery

Invasive fungal infection or mucormycosis is almost always confined to the patients with altered host defenses such as in transplant recipients, diabetics or patients with malignancies. Hypergycemia or uncontrolled diabetes, particularly diabetes acidosis is considered as the strongest and very well known risk factor for mucormycosis. It has spread like fire amongst the active COVID-19 and post COVID-19 diabetic patients. Many studies across the world have established the definitive severity of SARS-CoV-2 infection amongst diabetic patients.

Hemangiomas are usually congenital benign vascular tumors mostly found over the skin of head and neck. Tongue hemangiomas are relatively rare. Its treatment may include corticosteroid and beta-blocker therapy, interferon, sclerotherapy using bleomycin, cryotherapy, etc., but surgical therapy is the treatment of choice for solitary hemangioma. Transoral robotic surgery for hemangioma in the anterior tongue can be an added indication for robot-assisted procedure. Robotic technology offers numerous advantages and it can be a promising alternative in dealing with difficult oral cavity lesions like hemangioma.

The COVID-19 pandemic has resulted in a deep impact on the health-care system, which has changed the medical and surgical practice in many ways. The impact is so much that the average salary of an otolaryngologist has dropped to one-tenth only because of patient's fear and panic state. Several recent guidelines have been published in the wake of the COVID-19 (coronavirus disease) pandemic in 2019, considering the safety of both the patient and the health-care providers. [1] Almost all branches of surgery recommended suspension of the elective surgeries. The increased risk of contagion is especially for anesthetists, dentists, otolaryngologists, head-and-neck surgeons, and ophthalmologists. Otolaryngologists have a significant danger from COVID-19. Around the globe, many ENT surgeons are affected by it. In a report (April 2020) from Italy, Greece, and Iran, at least twenty otolaryngologists hospitalized and two already died in the UK. [2] The risks and benefits should be appropriately weighed before any intervention. A negative test result does not necessarily rule out the infection and hence all surgeries should be regarded as high risk even with a preoperative COVID-19 testing because the false-negative rate may vary between 15% and 25%. [3] The management of ENT and head-and-neck surgical cases represents a unique challenge in the COVID-19 times. In few circumstances such as head-and-neck malignancies, the treatment remains a high priority. The risk of COVID-19 collateral exposure during surgery is high. [4] Hence, the reassessment of the situation becomes vital, and best management should be provided to these patients.The objective of this article is to bring out the advantages of robotic-assisted surgery (RAS) for both the patients and the health-care workers as compared to the conventional approaches in ENT and head-and-neck surgery during COVID-19 times.