• Ashish Chugh, Prashant Punia, Sarang Gotecha, Ishant Rege, and Vinod Shinde.
• Department of Neurosurgery, Dr D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India.
• World Neurosurg. 2023 Apr 1; 172: e335e342e335-e342.

BackgroundOsteonecrosis in mucormycosis is a rare phenomenon and has been reported usually following trauma or in immunocompromised individuals. Osteonecrosis of skull as a complication of mucormycosis is a rare presentation, which makes the study ever so rare and interesting.MethodsWithin 6 months, a total of 114 patients presented with mucormycosis as COVID-19 sequel, 60 of whom underwent form of endoscopic sinus debridement. Six of these 60 patients presented with frontal bone osteonecrosis and were included in the study. All 6 patients presented within a time period of 2-4 months' post FESS.ResultsOne of the 6 patients succumbed to her illness. Another patient presented with local recurrence after 3 months, for which she underwent resurgery and debridement. The other 4 patients showed gradual recovery and are without symptoms or radiologic progression at 6-month follow-up.ConclusionsOsteonecrosis in mucormycosis is a rare phenomenon, and the 2 entities have rarely been reported together. The disease usually limits itself to the frontal bone only, and pathogenesis for spread is due to a vicious cycle of infection and ischemia. Prompt diagnosis via imaging, aggressive surgical debridement with a good antifungal cover, good patient compliance, and regular follow-up form the mainstay of treatment.Copyright © 2023 Elsevier Inc. All rights reserved.

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