Introduction and importance
The impact of Covid-19 pandemic on the incidence and pattern of Mucormycosis (the black fungus), has increased sharply and is featured as an epidemic within a pandemic. The majority of cases were detected at late stages, which decreases the chances of survival.
Case presentation
The authors present a case of an immunocompetent male patient diagnosed with left orbital apex syndrome post covid-19 infection, which necessitated orbital exenteration. He was later hospitalized in a quarantine facility and an area of skin breakdown on his left cheek was noted and surgical debridement performed. Later, He presented to our institution with left hemifacial skin loss, exposing the underlying diseased bone. A multidisciplinary team examined the patient clinically and radiographically, reaching a primitive diagnosis of secondary cutaneous Mucormycosis due to rhino-orbital Mucormycosis, with no cavernous sinus thrombosis nor cranial extension. Radical surgical and medical treatments were given and he had an uneventful recovery. Unfortunately, he died 5 days after the reconstructive surgery with Anterolateral Thigh (ALT) flap.
Clinical discussion
The dual effect of both (covid-19) and its' associated Mucormycosis, predispose patients to increased risk of pressure injuries including Medical device related pressure injuries. Survivors of Mucormycosis are high-risk patients, and planning their reconstruction by free flaps is challenging. However, delayed reconstruction is always recommended.
Conclusion
Early diagnosis and management of covid-19 associated Mucormycosis should be prioritized. Moreover, surgical debridement of necrotic tissues should not be delayed due to an unavailable or negative histopathology.
Mucormycosis is an uncommon acute invasive fungal infection that affects immunocompromised patients. It progresses rapidly and has poor prognosis if diagnosed late. Early detection, control of the underlying condition with aggressive surgical debridement, administration of systemic and local antifungal therapies, hyperbaric oxygen as adjunctive treatment improves prognosis and survivability.
Highlights
Intramuscular hemangioma is a relatively rare benign vascular tumor of the skeletal muscles.
The initial diagnosis of Intramuscular hemangioma is complicated due to low incidence and variation of symptoms.
Intramuscular hemangioma in the zygomaticus major muscle is extremely rare.
Background: Mandibular reconstruction following bony resection is crucial in cases of oral and mandibular tumors. Complications such as infection, plate exposure, or plate fracture can occur because of some risk factors after these reconstructive surgeries. Objectives: The purpose of this study were to report some of the postoperative complications of reconstruction plates, and to analyze the risk factors associated with those complications.
Patients and methods:We analyzed clinical and radiological data of 19 patients who required mandibular reconstructive surgery. The complications related to plates were recorded and used as an objective measure of outcome. Results: Plate-related complications developed in 8/19 patients. The complications involved screw loosening (n=2), plate fracture (n=2), plate exposure (n=3), and heat sensitivity (n=1). No significant differences were found in plate survival rate in relation to age or sex. Moreover, complications associated with plates developed in 73.68% of the patients with defect in the mandibular body crossing the midline of the mandible. Radiotherapy decreased the survival rate of the plates, as 60% of the irradiated patients had a higher risk of plate-related complications. and angle area and 100% of the patients who had defect crossing the midline of the mandible. Radiotherapy decreased the survival rate of the plates, as 60% of the irradiated patients had a higher risk of plate-related complications. Conclusion: The survival rate of mandibular reconstruction plate relies on mechanical and biological risk factors in terms of site of mandibular defects and radiation therapy, respectively.
HighlightsShedding light on the aggressive nature and rare incidence of Melanotic Neuroectodermal Tumour of Infancy (MNTI).Detailing different clinical and radiographic features of MNTI.Outlining the management of MNTI and postoperative follow-up regimen.Emphasising the importance of early diagnosis and surgical intervention in Melanotic Neuroectodermal Tumour of Infancy.
Buccal bifurcation cyst (BBC) is a rare inflammatory odontogenic cyst, which commonly affects children in the first decade of life. We report a case of a seven-year-old healthy boy with bilateral BBC, which involved unerupted incomplete permanent mandibular first molars. A review of the literature in English language revealed few similar cases. We reviewed 16 manuscripts of bilateral mandibular BBC, reporting a total of 20 cases since 1970. The clinical features of bilateral mandibular BBC summarized here could assist specialists with an accurate diagnosis and provide patients with optimal management.
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