MRI Findings of Rhino-Orbito-Cerebral Post-COVID 19 Mucormycosis – A Retrospective Study

Background: Rhino-orbital-cerebral-mucormycosis (ROCM) is a fatal, opportunistic fungal infection. There was a considerable increase in the incidence of ROCM during the second wave of the COVID-19 pandemic. Dentists should be aware of the varied magnetic resonance imaging (MRI) presentations of ROCM, as they may be the first to encounter patients with signs and symptoms of mucormycosis. Objective: To evaluate the MRI findings and pattern of spread of the disease in post-COVID Rhino-orbito-cerebral mucormycosis patients Methods: This was a retrospective observational study. Pre-operative cases with MRI evidence of invasive fungal sinusitis were scrutinized and the findings were entered in a structured data entry sheet. Results: In this study 60 post COVID patient’s MRI data that underwent pre-operative evaluation for Mucormycosis was evaluated. The total number of males was 38 and females 22 with an age range of 30 to 82. Pansinusitis was noted in 16 out of the 60 cases, the maxillary sinus n = 11 (18.3%) and a combination of ethmoid, maxillary, and the sphenoid sinuses n = 10 (16.7%) were the most common presentations. Extension of the disease to the orbit was noted in n = 29 (48.3%) of the cases. Intracranial extension was noted in n = 11 (18.3%) of the patients. Alveolar bone involvement was present in n = 29 (48.3%) and hard palate involvement in n = 11 (18.3%) of the patients. Conclusion: An array of MRI findings was seen in the present study. The maxillary sinus was the most predominant sinus to be involved and the spread of the disease was greatly attributed to the adjacent structures involved.