Physiotherapy Management for Surgical Defect of Operated Mucormycotic Osteomyelitis of Maxilla: Post COVID-19

Abstract

The maxilla is among the jaw bones with a lot of blood flow. Maxillary bone necrosis is uncommon and can be caused by infection, trauma, or unusual metabolic abnormalities. The maxilla is a vital bone that forms the roof of the mouth cavity. Mucormycosis is a prevalent fungus that infects the maxilla, particularly in diabetic and immune-compromised people and post-COVID-19 patients. Osteomyelitis is an inflammatory condition affecting the bone and marrow tissues. It is an opportunistic infection that occurs due to the host's susceptibility to illness due to the complication of other diseases. The patient, in this case, has the chief complaint of a defect in the palate. Based on a CT brain, buccal X-Ray, and HRCT scan of Thorax. The patient's condition was diagnosed as a surgical defect in a post-operated case of mucormycotic osteomyelitis of maxilla post-COVID-19 infection. The right lower lobe's posterior segment noted a tiny soft tissue density nodule. The operated case of a surgical defect of mucormycotic osteomyelitis of maxilla post-COVID-19 infection was treated with a surgical intervention that is surgical curettage and debridement of the left maxillary sinus, bilateral fibrotomy, and reconstruction with bilateral nasolabial flap under general anesthesia. However, our objective is to enhance the quality of life, increase ventilation, increase the shoulder joint's range of motion, and enhance the joint play of the temporomandibular joint so that the patient can go back to his usual activities without difficulty. A complete pulmonary rehabilitation plan was designed to meet the patient's objectives, executed, and followed for one month. It comprised myriad interventions like bedside sitting, facial expression exercises, mouth opening exercises, neck exercises, dynamic quadriceps and hamstring, active range of motion exercises for shoulder joints, thoracic expansion exercises, and breathing exercises like diaphragmatic breathing.