Ansel Mucormycosis Staging and Outcome Evaluation Score: Our Experience in Soaring Stage of Mucormycosis

Indian J Otolaryngol Head Neck Surg. 2024 Feb;76(1):118-122. doi: 10.1007/s12070-023-04103-7. Epub 2023 Aug 29.

Abstract

To propose Mucormycosis staging and Outcome evaluation score. (i) To provide method of conveying clinical experience to others without ambiguity. (ii) To facilitate an estimation of prognosis. (iii) To provide useful information for treatment decision. Retrospective observational study. Tertiary care center, Rajkot. 556 confirmed operated case of mucormycosis. It was a single center observational study of 556 confirmed cases of mucormycosis. In suspected cases of fungal infection, clinical symptoms were noted along with covid history and comorbid condition. Clinical findings were noted after nasal endoscopy. Rest neurological examination was done to rule out CNS involvement. Representative sample from nasal mucosa sent for microbiological examination. MRI PNS with Brain and Orbit was advised. After surgery, specimen was sent for histopathological confirmation. We reported most common age group was 51-60 years. 52% cases presented early with only nasal involvement and 1.8% cases with late cerebral involvement presentation. From recorded all above findings we have described this diseases progression in 4 components limited to nasal, orbital, palate and/or skull base, cerebral involvement. It is bases on anatomical progression on clinical and radiological findings. Considering all four components, staging system is designed that includes stage I to stage Vb. Outcome evaluation score designed to consider factors like patient's age, comorbidity, stage of disease while presentation, IV antifungal coverage and patient's psychological condition. Our clinical and radiological diagnostic staging and outcome evaluation score may helpful for others for early and better management of mucormycosis.

Keywords: Ansel; Mucormycosis; Staging.