Published: 2021-11-25

Bilateral maxillectomy via mid-facial degloving approach in an extensive case of post-Coronavirus disease invasive fungal sinusitis

Sampath Kumar Singh, Kuthadi Gayatri, Mounika Reddy Yalaka


Coronavirus disease associated invasive fungal sinusitis has affected many and several have succumbed to the disease during the second wave of COVID-19 pandemic. Mucormycosis is a rare, opportunistic, fulminant, angioinvasive fungal infection caused by Rhizopus species of the order Mucorales. It mainly affects immunocompromised individuals, predisposed by diabetes mellitus, corticosteroids, immunosuppressive therapy, haematological malignancies and organ transplantation. We reported here a case of a 45 years old male with past history of Coronavirus disease, presenting with symptoms of invasive fungal sinusitis. With this case we emphasised on use of an alternate approach for bilateral total maxillectomy via midfacial degloving approach instead of a classical external Weber Ferguesen incision in extensive cases with several associated co-morbidities. Mid facial degloving approach is a combination of intraoral and intranasal incisions made to access the midface without any external incision. This approach is advantageous in comparatively having less complication rate, less morbidity and excellent cosmetic outcome.


Mucormycosis, Invasive fungal sinusitis, Midfacial degloving approach, Maxillectomy, Coronavirus

Full Text:



Portmann G, Retrouvey DH. Le cancer du nez, des fosses nasales, des cavit├ęs accessoires et du naso-pharynx. G Doin. 1927.

Casson PR, Bonanno PC, Converse JM. The midface degloving procedure. Plast Reconstr Surg. 1974;53(1):102-3.

Sachs ME, Conley J, Blaugrund S, Rabuzzi DD, Price J. Degloving approach for total excision of inverted papilloma. The Laryngoscope. 1984;94(12):1595-8.

Price JC, Holliday MJ, Johns ME, Kennedy DW, Richtsmeier WJ, Mattox DE. The versatile midface degloving approach. The Laryngoscope. 1988;98(3):291-5.

Eze NN, Wyatt ME, Bray D, Bailey CM, Hartley BE. The midfacial degloving approach to sinonasal tumours in children. Rhinology. 2006;44(1):36-8.

Kang M, Jee YJ, Lee DW, Jung SP, Kim SW, Yang S, et al. Midfacial degloving approach for management of the maxillary fibrous dysplasia: a case report. Maxillofac Plast Reconstr Surg. 2018;40(1):38.

Kantas I, Tzindros G, Papadopoulou A, Marangos N. Midfacial Degloving: The Best Alternative for Treatment of Trans-sphenoidal Meningocele of the Pterygopalatine Fossa. Skull Base. 2006;16(2):117-22.

Data citation

Dear Editor, Have made the changes as requested. and have uploaded the revised manuscript along with figures jpeg format. Kindly let me know if any more changes are required