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Subperiosteal inferior maxillectomy in mucormycosis patients: case series

Published online by Cambridge University Press:  13 October 2021

V Wadhwa ,
D Chaudhary Open the ORCID record for D Chaudhary [Opens in a new window] ,
R Meher ,
P K Rathore ,
V Kumar ,
S Soni  and
N Kumar
V Wadhwa
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College, New Delhi, India
D Chaudhary*
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College, New Delhi, India
R Meher
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College, New Delhi, India
P K Rathore
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College, New Delhi, India
V Kumar
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College, New Delhi, India
S Soni
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College, New Delhi, India
N Kumar
Affiliation:
Department of Otorhinolaryngology, Maulana Azad Medical College, New Delhi, India
*
Author for correspondence: Dr D Chaudhary, Department of Otorhinolaryngology, Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi 110002, India E-mail: deepikachaudhary19@gmail.com
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Abstract

Objective

Mucormycosis is a rapidly progressive and fulminant fungal infection mainly affecting the nose and paranasal sinuses and often requiring aggressive surgical debridement, which commonly includes inferior maxillectomy. Conventional inferior maxillectomy involves removal of the bony hard palate and its mucoperiosteum. This can lead to formation of an oroantral fistula and thereby increase the morbidity in these patients leading to prolonged rehabilitation. Subperiosteal inferior maxillectomy involves sparing of the uninvolved mucoperiosteum of the hard palate. This flap is used for closure of the oroantral fistula, which preserves the functional capabilities of the patient, such as speech, mastication and deglutination.

Method

This case series describes the experience of using the technique of mucosa-preserving subperiosteal inferior maxillectomy in five patients with mucormycosis.

Results

With the technique used in this study, complete oronasal separation was achieved in all six patients. The overall surgery time was also decreased when compared with free tissue transfer. Patients also did not have to bear the weight of prosthesis.

Conclusion

Mucoperiosteal palatal flap-preserving subperiosteal inferior maxillectomy is an excellent approach for all patients with mucormycosis and healthy palatal mucosa.

Keywords

ImagingInformed ConsentSwallowing
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 2 , February 2023 , pp. 225 - 230
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr D Chaudhary takes responsibility for the integrity of the content of the paper

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