Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jun 14:22:e20.
eCollection 2022.

Reconstruction in Rhino-Orbito-Cerebral Mucormycosis Survivors: A Systematic Review

Ved Prakash Rao Cheruvu  1 , Manal M Khan  1
Affiliations
Review

Reconstruction in Rhino-Orbito-Cerebral Mucormycosis Survivors: A Systematic Review

Ved Prakash Rao Cheruvu et al. Eplasty. .

Abstract

Background: The COVID-19 pandemic has affected the entire world tremendously. Particularly during the second wave in India, a dangerous complication followed in the form of COVID-19-associated mucormycosis. On June 7th, 2021, the Indian Union Health Minister stated that 28,252 cases of mucormycosis were reported from 28 states/Union territories in the country.

Methods: A PubMed search was conducted for English-language studies published from 1988 through May 22, 2021 using the terms "reconstruction AND mucormycosis."

Results: The search yielded 102 results. After excluding the articles not describing reconstruction in mucormycosis, 53 abstracts were screened. Then 34 articles dealing with reconstruction in non-ROC regions were excluded. The full text of 16 articles was reviewed. Additionally, 3 articles were identified from the reference search. Due to the aggressive debridements, rhino-orbito-cerebral mucormycosis survivors may be left with complex tissue defects with significant functional and aesthetic impairments. It is essential to offer reconstructive solutions that improve their quality of life. As far as the timing of reconstruction is concerned, the consensus is in favor of delayed reconstruction after ensuring that the infection has been eliminated/controlled and that there are no recurrences. The most common defects encountered were the ones that resulted from orbital exenteration and excision of a varying extent of the involved contiguous bony and soft tissue structures. Reconstruction with pedicled flaps was preferred rather than free flaps, especially in the cases where the infection was not eliminated completely. Adjuvant antifungal therapy was used in most of the cases. Long-term follow-up was considered essential to detect and treat recurrences.

Conclusions: A multitude of options are available for reconstruction in rhino-orbito-cerebral mucormycosis including skin grafts, pedicled flaps, free flaps and in some cases implants and prosthetics. These can be utilized to give as much as functional and aesthetic restoration as possible to the patient.

Keywords: COVID-19; free tissue flaps; mucormycosis; orbit evisceration; quality of life.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
PRISMA flowchart, showing the selection process of the articles included in this review. ROC indicates rhino-orbito-cerebral.
FIGURE 2
FIGURE 2
Proposed algorithm for the reconstruction of tissue defects in ROCM. a: Split-thickness skin graft; b: Pectoralis major myo-cutaneous flap; c: Radial artery forearm flap; d: Anterolateral thigh flap; e: Rectus abdominis myo-cutaneous flap; f: Vertical rectus abdominis myo-cutaneous flap; g: Serratus anterior flap
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ritchie H, Ortiz-Ospina E, Beltekian D, et al. . Coronavirus Pandemic (COVID-19). Our World Data. Published online March 5, 2020. https://ourworldindata.org/covid-deaths. Accessed July 11, 2021.
    1. Raut A, Huy NT. Rising incidence of mucormycosis in patients with COVID-19: another challenge for India amidst the second wave?. Lancet Respir Med. 2021;9(8):e77. doi:10.1016/S2213-2600(21)00265-410.1016/S2213-2600(21)00265-4 - DOI - DOI - PMC - PubMed
    1. Singh P. Black fungus: Here is a list of states with highest number of mucormycosis cases. Hindustan Times. Published May 21, 2021. https://www.hindustantimes.com/india-news/black-fungus-states-with-highe.... Accessed June 17, 2021.
    1. Singh AK, Singh R, Joshi SR, Misra A. Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India. Diabetes Metab Syndr. 2021;15(4):102146. doi:10.1016/j.dsx.2021.05.01910.1016/j.dsx.2021.05.019 - DOI - DOI - PMC - PubMed
    1. Zee Media Bureau. 28,252 mucormycosis cases with 86% history of COVID from 28 states/UTs: Harsh Vardhan. Zee News. Published June 7, 2021. https://zeenews.india.com/india/28252-mucormycosis-cases-with-86-history.... Accessed June 17, 2021.

LinkOut - more resources