Mucormycosis is an opportunistic fungal infection indicating a high mortality rate. Among six varieties of involved sites, rhino cerebral mucormycosis (RCM) is not the most uncommon. During the COVID-19 pandemic, with the increase, in predisposing conditions incidence rate of mucormycosis progressed. For aggressive treatment, an early diagnosis can be armored to reduce morbidity and mortality. Clinically RCM poses non-specific symptoms and signs delaying diagnosis. This is associated with orbital cellulitis and sinusitis, one-sided headache behind the eye, diplopia, blurring of visions, nasal congestion, rhinorrhea, epistaxis, nasal hypoesthesia, facial pain and numbness, and a history of black nasal discharge. Not commonly the complications of cranial nerve involvement have been reported. In the present case series, three presentations of facial nerve palsy in COVID-19 associated with mucormycosis are added to the literature database.
IntroductionAn odontogenic keratocyst (OKC) is a benign intraosseous lesion with potential to demonstrate aggressive and invasive behavior. The aim of this retrospective study was to analyze the imaging features of the OKC using cone-beam computed tomography (CBCT) and to evaluate the association between the internal structure of the lesion and the effect of the lesion on surrounding structures. MethodsOverall, 32 CBCT scans of histopathologically diagnosed cases of OKC were analyzed retrospectively. The following variables were analyzed: anatomic location of the lesions (mandible body (right/left), ramus (right/left), mandible body+ramus (right/left), maxilla (right/left), and both jaws), the internal structure of the lesion (unilocular/multilocular), and the effect of the lesion on the surrounding anatomical structures (involvement of the inferior alveolar nerve canal (IANC), displacement of the IANC, cortical expansion, displacement of the tooth, resorption of the root, associated impacted tooth, associated missing tooth). We also looked for the association between the internal structure and the effect of the lesion on anatomic structures. ResultsOut of 32 cases, 29 (90.6%) cases involved the mandible alone. Statistically significant association (p-value 0.005) was present between the internal structure and mean age of presentation as well as between the internal structure and impacted tooth (p-value 0.027). The association between the internal structure and other variables was statistically not significant. ConclusionsThe radiographic features of OKCs can be variable, and these lesions have a considerable effect on the tooth, IANC, and cortical bone. Significant association was found between the internal structure, age, and impacted tooth. Since OKCs have a high recurrence rate, CBCT is advised for evaluating the extent and location of any cortical perforations.
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