Utility of Intraoperative Scoring System in Rhino-orbital Mucormycosis as a Prognostic Tool| ACTA Otorhinolaryngologica Italica

Abstract

OBJECTIVE: To assess the utility of intraoperative scoring system for mucormycosis and to assess the prognosis by comparing the score with postoperative outcome.

METHODS: This study was conducted among 80 patients with mucormycosis who underwent surgical management with mandatory pterygopalatine fossa and infratemporal fossa exploration. All cases were scored using our intraoperative scoring assessment tool. Postoperative outcomes in terms of favourable prognosis and mortality were evaluated and compared with demographics, clinical history and intraoperative findings.

RESULTS: An intraoperative score of more than 25 is statistically significant in predicting mortality (P<0.0001) and 86.7% of them succumbed to the disease. Statistical significance of mortality (P<0.05) was observed in those with involvement of pterygopalatine fossa (78.9%), orbit (73.7%), infratemporal fossa (57.9%), cribriform plate (36.8%) and those with history of intake of antiviral drugs (47.4%), use of supplemental Oxygen (31.6%) and renal failure (26.3%).

CONCLUSIONS: This study has enabled better prediction of postoperative prognosis in mucormycosis and has reiterated the importance of exploration of pterygopalatine fossa and infratemporal fossa in management and prognostication of invasive fungal sinusitis.