Post maxillectomy rehabilitation and amelioration of quality of life of post-COVID rhinocerebral mucormycosis patients using obturator: A case series

Abstract

A BSTRACT Mucormycosis, a rare fungal infection seen in diabetes, is now very frequent owing to the deadly triad of COVID-19 infection, diabetes, and rampant use of corticosteroids. Early diagnosis and treatment can reduce the mortality and morbidity of this lethal fungal infection. Treatment principles may include antifungal agents along with surgical debridement or resection. The surgically removed palate can have a devastating effect on the appearance and speech of the patient. Obturators allow patients to eat and drink without any suspicion of food entering the oroantral cavities/pharynx during mastication. This case series presented the prosthodontic rehabilitation of nine post-COVID rhinocerebral mucormycosis-infected patients with complete or partial defects.

Prosthodontic rehabilitation of patients with Rhinocerebral mucormycosis: An update of evidence

“…27 Recent case reports have documented 10 patients with history of post covid mucormycosis (PCM) who were efficiently rehabilitated with obturators (Table 1, Table 2). [19][20][21][22][23]28,29 Diabetes mellitus was the most significant associated risk factor in 27 patients followed by Acute Myeloid Leukemia based on data reported here and earlier by Santos et al Rhizopus oryzae has been reported to be the most common causative organism as high glucose levels, insulin resistance and ketoacidosis encourage its growth. 30 Amphotericin B remained the first-choice drug followed by Posaconazole.…”

“…5 I. E. Ali, et al reported prosthodontic rehabilitation of post mucormycosis defects from 30 case reports published between 2010 to 2021. 24 18 more patients on PubMed [17][18][19][20][21][22][23] and 9 on google scholar [Table 2] were reported with history of mucormycosis followed by fabrication of palatal obturator from 2020 to May 2023. Mean age and gender wise distribution of patients who were rehabilitated after surgical management of mucormycosis has been depicted in Figure 1.…”