Preservation of Palatal Mucosa in Rhinomaxillary Mucormycosis Cases

Mucormycosis is an aggressive, life-threatening infection that requires prompt diagnosis and early treatment. Depending on the severity of the disease, rhinomaxillary mucormycosis (RMM) may necessitate maxillectomy, ranging from partial to total removal. The implementation of primary closure leads to improved functional ability by creating a separation between the oral and nasal cavities, which facilitates oral intake and reduces the duration of nasogastric feeding. This, in turn, enhances the patients' quality of life. The objective of this study was to evaluate the effectiveness of primary closure using palatal mucosa (PM) following maxillectomy in patients with RMM.

We conducted a retroprospective study to analyze the outcomes of 32 operated cases of rhinomaxillary mucormycosis (RMM). After maxillectomy, we preserved highly vascular uninfected palatal mucosa to close the maxillary defect. The study spanned 4 months, encompassing 4 months of retrospective data collection and 3 months of prospective data collection.

During the 3rd month follow-up, complete closure and uptake of the flap were observed in 22 patients. At the 6-month follow-up, 28 participants exhibited total uptake of PM, with no oro-antral/nasal communication.

This study concludes that in most circumstances, employing a PM flap to close the defect after maxillectomy and surgical debridement is a successful approach as it reduces the occurrence of oro-antral/oro-nasal communication.