{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T01:14:38Z","timestamp":1792458878201,"version":"4.5.0"},"reference-count":18,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T00:00:00Z","timestamp":1758326400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Mucormycosis is a rare but potentially fatal opportunistic fungal infection with high morbidity and mortality rates despite aggressive treatment. Rhinocerebral mucormycosis represents the most common form, requiring prompt recognition and multidisciplinary management. Case Presentation: We report a 60-year-old female with glucose intolerance who developed extensive rhinocerebral mucormycosis involving the right maxillary sinus, orbit, and skull base. Despite initial antifungal therapy with amphotericin B, rapid disease progression necessitated radical surgical intervention including complete right hemimaxillectomy, orbital enucleation, and partial sphenoid bone resection with carotid siphon exposure. Initial reconstruction using a free scapular osteocutaneous flap failed due to vascular compromise, requiring salvage coverage with a temporalis muscle flap. Postoperatively, the patient recovered without cerebrovascular complications. Long-term rehabilitation involved implant-supported prosthetic reconstruction with osseointegrated implants placed in the remaining maxilla and fabrication of a custom obturator prosthesis to restore facial support and masticatory function. Conclusions: This case demonstrates the aggressive nature of mucormycosis requiring extensive surgical resection and highlights the challenges of reconstruction in infected tissues. While free flap reconstruction offers theoretical advantages, local tissue options provide reliable coverage when microvascular procedures fail. Comprehensive multidisciplinary care including prosthetic rehabilitation can achieve satisfactory functional outcomes following radical resection.<\/jats:p>","DOI":"10.3390\/reports8030187","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T08:37:39Z","timestamp":1758530259000},"page":"187","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Aggressive Mucormycosis with Extensive Craniofacial Involvement: A Case Report of Radical Surgical Management and Prosthetic Rehabilitation"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7732-1207","authenticated-orcid":false,"given":"Alice","family":"Marzi Manfroni","sequence":"first","affiliation":[{"name":"Maxillofacial Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Arcuri","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Spinzia","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjon","family":"Sako","sequence":"additional","affiliation":[{"name":"Surgery Unit, University Trauma Hospital, 1016 Tirana, Albania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Lagan\u00e0","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.idc.2024.11.008","article-title":"Mucormycosis","volume":"39","author":"Czech","year":"2025","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"217","DOI":"10.2217\/fmb-2022-0141","article-title":"Mucormycosis, past and present: A comprehensive review","volume":"18","author":"Gupta","year":"2023","journal-title":"Futur. Microbiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.idc.2021.03.009","article-title":"Mucormycosis","volume":"35","author":"Steinbrink","year":"2021","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1097\/QCO.0000000000000976","article-title":"Mucormycosis: Update on clinical presentation, diagnosis, and treatment","volume":"36","author":"Kontoyiannis","year":"2023","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1007\/s00701-018-3486-z","article-title":"Traumatic subarachnoid hemorrhage related to ophthalmic artery avulsion: A case report","volume":"160","author":"Prior","year":"2018","journal-title":"Acta Neurochir."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1093\/mmy\/myx101","article-title":"Challenges in the diagnosis and treatment of mucormycosis","volume":"56","author":"Skiada","year":"2018","journal-title":"Med. Mycol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1097\/ICU.0000000000000892","article-title":"Rhino-orbital mucormycosis","volume":"33","author":"Ryu","year":"2022","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e533","DOI":"10.1016\/j.ijid.2011.02.005","article-title":"Mucormycosis in immunocompetent patients: A case-series of patients with maxillary sinus involvement and a critical review of the literature","volume":"15","author":"Mignogna","year":"2011","journal-title":"Int. J. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"224","DOI":"10.4103\/ams.ams_54_23","article-title":"Surgical Rehabilitation of a Continuous Orbital and Maxillary Defect from Rhino-Orbital Mucormycosis Utilising Digital Technology\u2014A Case Report","volume":"13","author":"Rathee","year":"2023","journal-title":"Ann. Maxillofac. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1089\/sur.2006.039","article-title":"Invasive mucormycosis of the maxillary sinus: Extensive destruction with an indolent presentation","volume":"9","author":"Odessey","year":"2008","journal-title":"Surg. Infect."},{"key":"ref_11","first-page":"e40932","article-title":"The Radiological Spectrum of Rhino-Oculo-Cerebral Mucormycosis","volume":"15","author":"Suman","year":"2023","journal-title":"Cureus"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"S112","DOI":"10.4103\/jomfp.JOMFP_163_17","article-title":"Mucormycosis in immunocompetent patient resulting in extensive maxillary sequestration","volume":"22","author":"Venkatesh","year":"2018","journal-title":"J. Oral Maxillofac. Pathol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"187","DOI":"10.36518\/2689-0216.1191","article-title":"A Case Report: Utilization of Topical Amphotericin in Postoperative Mucormycosis","volume":"2","author":"Wang","year":"2021","journal-title":"HCA Healthc. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Keller, F., Antoni, H., Minarcikova, P., Hrdy, O., and Gal, R. (2023). Mucormycosis in a Severe Trauma Patient Treated with a Combination of Systemic Posaconazole and Topical Amphotericin B-Case Report. Antibiotics, 12.","DOI":"10.3390\/antibiotics12101489"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1097\/SCS.0000000000009512","article-title":"Double Arterialized Scapular Tip Free Flap for Mandibular Reconstruction","volume":"34","author":"Arcuri","year":"2023","journal-title":"J. Craniofac. Surg."},{"key":"ref_16","first-page":"13","article-title":"Implants outcome inserted in different sites","volume":"34","author":"Beltramini","year":"2020","journal-title":"J. Biol. Regul. Homeost. Agents."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e128","DOI":"10.1097\/SCS.0000000000006855","article-title":"Orbital Floor Fractures Comparing Different Kinds of Reconstruction: A Proposal for Restoration of Physiological Anatomy","volume":"32","author":"Spinzia","year":"2021","journal-title":"J. Craniofac. 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Am."}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/8\/3\/187\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:46:29Z","timestamp":1760035589000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/8\/3\/187"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,20]]},"references-count":18,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["reports8030187"],"URL":"https:\/\/doi.org\/10.3390\/reports8030187","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,20]]}}}