RESUMEN
The study aimed to determine clinical presentation, contributing factors, medical and surgical management, and outcome of patients with coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM). A cross-sectional, single-center study was conducted on patients receiving multidisciplinary treatment for mucormycosis following the second wave of COVID-19 pandemic from April to June 2021 in India. Clinicoepidemiological factors were analyzed, 30-day overall survival and disease-specific survival were determined, and t-test was used to determine the statistical significance. A total of 215 patients were included in the study, the cases were stratified into sino-nasal 95 (44.2%), sino-naso-orbital 32 (14.9%), sino-naso-palatal 55 (25.6%), sino-naso-cerebral 12 (5.6%), sino-naso-orbito-cerebral 16 (7.4%), and sino-naso-orbito-palato-cerebral 5 (2.3%) based on their presentation. A multidisciplinary team treated patients by surgical wound debridement and medical therapy with broad-spectrum antibiotics and amphotericin B. Across all disease stages, cumulative 30-day disease-specific survival is 94% (p < 0.001, intergroup comparison, Breslow (generalized Wilcoxon) CI 95%) and overall 30-day survival is 87.9% (p < 0.001, intergroup comparison, Breslow (generalized Wilcoxon) CI 95%) (censored). Early identification, triaging, and proper multidisciplinary team management with systemic antifungals, surgical debridement, and control of comorbidities lead to desirable outcomes in COVID-associated mucormycosis. The patients with intracranial involvement have a higher chance of mortality compared to the other group. Supplementary Information: The online version contains supplementary material available at 10.1007/s12262-021-03134-0.
RESUMEN
Aim of study includes review on supra-auricular approach and its clearance of the tract including its branches and also its efficacy in reduction of recurrence when compared to standard technique. Prospective study in which 10 patients attending ENT opd with clinically diagnosed preauricular sinus undergoing supra-auricular approach under GA/LA, willing to participate in study were selected. An elliptical incision of the standard technique extended higher upward to pre- and supra-auricular temporal region. Plane of temporalis fascia was delineated. Skin, anterior to the sinus and tragus was separated. Soft tissue between the plane of temporalis fascia (deep limit) and the skin anterior to the sinus excised along with the piece of adjoining helical cartilage. This excised tissue contains the entire tract with its possible branches giving no room for recurrence. Patients were followed up for 6 months. 10 patient's data was updated and analyzed. No recurrence observed in all 10 patients. Supra auricular approach is useful and helpful technique for preauricular sinus tract excision with no recurrence rate. However further studies are required with large sample size.
