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Reconstructive cranial surgery for invasive and non-responsive mucormycosis
Preetham Dange1, Nazrin Hameed2, Ravi Sankar2
1Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
BMJ Case Reports
|September 15, 2023
Summary
A challenging case of invasive fungal sinusitis (mucormycosis) in a diabetic patient with COVID-19 is presented. Advanced surgical techniques and 3D-printed implants successfully managed this persistent infection.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Neurosurgery
Background:
- The COVID-19 pandemic saw increased mucormycosis incidence, particularly in diabetic patients.
- Corticosteroid and oxygen therapy during COVID-19 treatment are risk factors for invasive fungal infections.
Observation:
- A persistent case of frontal and ethmoid sinus mucormycosis in a diabetic male with a history of COVID-19.
- The infection resisted initial endoscopic sinus surgery and re-exploration with antifungal therapy.
Findings:
- A bifrontal craniotomy with complete sinus exenteration was required for infection control.
- Reconstruction utilized a custom 3D-printed titanium cranioplasty mesh, which was MRI-compatible.
Implications:
- This case highlights the aggressive nature of mucormycosis in immunocompromised patients.
- Advanced surgical reconstruction techniques, including 3D printing, are crucial for managing complex sinonasal fungal infections.
