Evaluation of the Imaging Characteristics of Rhino-Orbital Cerebral Mucormycosis

Background: Mucormycosis is a fungal infection with diverse clinical manifestations, the most common of which, i.e., the classical form of rhinoorbital cerebral mucormycosis (ROCM), has had a significant prevalence among patients recovered from COVID-19.We aimed to investigate the findings of ROCM imaging recorded at Imam Khomeini Hospital in Ahvaz, Iran, in 2022.Methods: This retrospective study reviewed the files of patients definitively diagnosed with mucormycosis and COVID-19.Imaging procedures performed on patients included non-contrast CT scans (CT imaging protocol: from vertex to mandible without contrast for evaluating sinus contents, bone erosion, osteomyelitis, pre-sinus or orbital invasion).Key imaging findings were assessed and documented, and findings were evaluated. Results:The mean age of subjects was 53.11 14 years, with the majority being male (55.3%).All subjects had nasal and sinus involvement, but their brains were unaffected.Approximately 36% of subjects had ocular involvement.In imaging findings, left pterygopalatine involvement had the highest prevalence (27.7%), while left extraocular muscle involvement had the lowest prevalence (4.3%).Patients with lamina papyracea and extraocular muscle involvement all had ocular involvement, which was statistically significant.Additionally, those with hard palate erosion had significantly higher ocular involvement rates (5 out of 6 cases with hard palate erosion). Conclusion:Rhino-orbital cerebral mucormycosis is associated with nasal and sinus involvement, and diabetes and male gender are predisposing factors to this disease.CT, as a complement to other clinical evaluations, dramatically aids in diagnosing and identifying the extent and complications of the disease.