A Novel Classification System for Oral Cavity Mucormycosis: a Hospital Based Cross-Sectional Study

Kranti Bhavana; Aiswarya Vaidyanathan; Naqoosh Haidry; Bhartendu Bharti; Anil Kumar; Peeyush Shivhare

doi:10.1007/s12663-023-01951-2

A Novel Classification System for Oral Cavity Mucormycosis: a Hospital Based Cross-Sectional Study

J Maxillofac Oral Surg. 2023 Dec;22(4):1139-1147. doi: 10.1007/s12663-023-01951-2. Epub 2023 Jun 28.

Authors

Kranti Bhavana¹, Aiswarya Vaidyanathan², Naqoosh Haidry², Bhartendu Bharti¹, Anil Kumar³, Peeyush Shivhare²

Affiliations

¹ Department of ENT, AIIMS, All India Institute of Medical Sciences, Phulwarisharif, Patna, Bihar 801507 India.
² Department of Dentistry, AIIMS, All India Institute of Medical Sciences, Phulwarisharif, Patna, Bihar 801507 India.
³ Trauma and Emergency medicine, AIIMS, All India Institute of Medical Sciences, Phulwarisharif, Patna, Bihar 801507 India.

PMID: 38105861
PMCID: PMC10719203 (available on 2024-12-01)
DOI: 10.1007/s12663-023-01951-2

Abstract

Background: Rhino-oculo-cerebral Mucormycosis (ROCM) is a well-known complication post-COVID-19 infection. The extension of this disease into the oral cavity is a grey area with no proper protocol for management of the same in the existing literature. Based on our experience in the management of oral extension, this study aims to propose a protocol to treat these cases.

Aim: To derive a classification for the surgeon from retrospectively collected data of 53 operated cases of oral Mucormycosis.

Settings and design: Hospital record-based cross-sectional study; evaluation of the previously treated 53 cases of oral extension of post-COVID-19 Rhino-oculo-cerebral Mucormycosis in the duration between May 2021 to August 2021. Follow-up for a period of 1 year.

Methods and material: Based on the preoperative data, 4 parameters were taken -Tooth tenderness, Tooth mobility, Palatal perforation, and Radiological findings. A clinical-radiological classification system was derived based on the intraoperative data from the OT notes and the preoperative findings corresponding to the 4 parameters.

Statistical analysis: The statistical analysis was done using SPSS for windows version 20 software (SPSS Inc., Chicago, IL, USA).

Results: Totally 220 cases of ROCM were recorded in our institute. Of this, 53 patients were treated for ROCM extending into the oral cavity. In 27 patients, we were able to achieve primary closure. In 26 patients, there was oro-antral communication after removal of the palate. Based on this data, we derived a protocol that may be used by the treating surgeon to manage oral cavity cases of ROCM, so that aggressive tissue resection may be avoided unnecessarily.

Conclusion: This protocol will help the treating surgeon to have a clearer outlook on treating this disease.

Keywords: Mucor; Mucormycosis; Oral; Palate; Surgery.

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