Abstract
Introduction The effect of the second wave of COVID-19 was immense in India, specifically in the
form of vicious COVID-19-associated mucormycosis. A higher number of radical debridements
are required for disease control in combination with antifungal drugs in cases of
COVID-19-associated mucormycosis, which results in complex maxillofacial defects.
We aimed to evaluate the clinical outcomes in patients with rhino-orbito-maxillary
defects due to COVID-19-associated mucormycosis undergoing a single stage delayed
free flap reconstruction.
Methodology This prospective, single-center, multisurgeon study was performed on eight patients
with COVID-19-associated rhino-orbito-maxillary mucormycosis in the department of
burns and plastic surgery. The postoperative clinical outcome was evaluated using
the University of Washington Quality of Life Questionnaire for patient's quality of
life (QOL), aesthetic numeric analog (ANA) scale for patient's satisfaction for aesthetics,
and the functional intraoral Glasgow scale for speech and deglutition at 1 and 3 months.
Results The median age of the study patients was 40 years, with 75% of the patients being
males. Diabetes mellitus (DM) was present in all the patients. Mucormycosis was diagnosed
within the first 3 months of COVID-19 infection. Maxillary defect was present in 62.5%
of patients, out of which 50% had bilateral maxillary defects. There was significant
improvement in the QOL and the aesthetics of patients from 1 to 3 months (p < 0.001). Speech and deglutition were also improved at 3 months, but the difference
was not statistically significant.
Conclusion Single stage delayed free flap reconstruction can be advocated in patients with COVID-19-associated
rhino-orbito-maxillary mucormycosis defect as there is considerable improvement in
patients' QOL, aesthetics, speech, and deglutition over a period of time.
Keywords
COVID-19 - COVID-19-associated mucormycosis - free flaps - mucormycosis - quality
of life
