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<p>Mucormycosis, an angioinvasive infection is caused by certain Mucorales of class zygomycetes such as Rhizomucor, Rhizopus, Cunninghamella etc. In majority, the surgical resection is aggressive which creates substantial defects of the orbit, face and oral cavity causing reduced quality of life, which seems inevitable. This necessitates the scope of rehabilitation but secondary to disease eradication to improve the patient’s quality of life. The post-surgical palatal defects of mucormycosis are remarkably different from the defects that result from tumour resection due to the unpredictable, indefinable advancement of the fungus and the probable requirement of additional debridement procedure. This study aims to compare the long-term surgical outcome in patients of mucormycosis who had palatal involvement (alveolus sparing) which was surgically resected and intraoperative rehabilitation was done by dividing these patients equally into surgical reconstruction using free flaps and prosthetic obturation. The patients were followed-up for 6&#xa0;months. The results were compared based on patients’ comfort, rehabilitative outcome, functioning scale including swallowing, speech, and overall post-operative outcome. Isolated hard palate defects post sinonasal mucormycosis debridement can be rehabilitated with radial free flap reconstruction and obturator prosthesis, however we recommend early rehabilitation with obturator prosthesis to have better quality of life outcome and to undergo permanent reconstruction with a free flap after a minimum duration of 3&#xa0;months once the fungal pathology has been completely cleared and patient is systemically recovered to have a better flap outcome.</p>

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Intra-operative Rehabilitation Dilemma in Rhinocerebral Mucormycosis Patients with Palate Involvement: Surgical Reconstruction or Prosthetic Obturation

  • 期刊论文

  • 发表日期：

    2025年9月8日

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  • Rajendra Dabaria,
  • Priyanshi Gupta,
  • Tarun Ojha,
  • Nikhil Kumar Soni,
  • Garima Katewa,
  • Shivi Mathur

摘要

Mucormycosis, an angioinvasive infection is caused by certain Mucorales of class zygomycetes such as Rhizomucor, Rhizopus, Cunninghamella etc. In majority, the surgical resection is aggressive which creates substantial defects of the orbit, face and oral cavity causing reduced quality of life, which seems inevitable. This necessitates the scope of rehabilitation but secondary to disease eradication to improve the patient’s quality of life. The post-surgical palatal defects of mucormycosis are remarkably different from the defects that result from tumour resection due to the unpredictable, indefinable advancement of the fungus and the probable requirement of additional debridement procedure. This study aims to compare the long-term surgical outcome in patients of mucormycosis who had palatal involvement (alveolus sparing) which was surgically resected and intraoperative rehabilitation was done by dividing these patients equally into surgical reconstruction using free flaps and prosthetic obturation. The patients were followed-up for 6 months. The results were compared based on patients’ comfort, rehabilitative outcome, functioning scale including swallowing, speech, and overall post-operative outcome. Isolated hard palate defects post sinonasal mucormycosis debridement can be rehabilitated with radial free flap reconstruction and obturator prosthesis, however we recommend early rehabilitation with obturator prosthesis to have better quality of life outcome and to undergo permanent reconstruction with a free flap after a minimum duration of 3 months once the fungal pathology has been completely cleared and patient is systemically recovered to have a better flap outcome.