Evidence map›Paper›PMID 40536687›Full record

Observational studyOral and maxillofacial surgery2025

Adjunctive use of posaconazole, hyperbaric oxygen therapy, and methylene blue for COVID-19-associated mucormycosis.

Sujata Mohanty, Neeraj Bansal, Anjali Verma, Hemavathy S, Arpit Gupta, Chayanika Sharma

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Oral and maxillofacial surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Sujata MohantyDepartment of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, 110002, India.ORCID http://orcid.org/0000-0002-1444-7191
Neeraj BansalDepartment of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, 110002, India. doc.neerajbansal@gmail.com.ORCID http://orcid.org/0000-0002-5835-9599
Anjali VermaDepartment of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, 110002, India.
Hemavathy SDepartment of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, 110002, India.
Arpit GuptaDepartment of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, 110002, India.
Chayanika SharmaDepartment of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, 110002, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe study aimed to assess the cumulative role of oral posaconazole, post-debridement Hyperbaric Oxygen (HBO) therapy, along with local application and steam inhalation with methylene blue as an adjunct to surgery to prevent further progression of COVID-19 associated sino-maxillary or mandibular mucormycosis.

methodsA retrospective observational study was conducted on patients diagnosed with sino-maxillary or mandibular mucormycosis associated with COVID-19. A total of 38 patients underwent surgical debridement and received adjunctive treatment with posaconazole, hyperbaric oxygen therapy, and local application and steam inhalation of methylene blue. Medical records were analyzed for COVID-19-related hyperglycemia, prolonged hospitalization, immunosuppressive/steroid therapy, and the use of iron or zinc supplements, which may be linked to increased mucormycosis incidence. Outcomes were evaluated for association with any concurrent infection, complications, need for sequential debridement, and further progression of disease.

resultsA total of 38 patients (range: 23-68) were included, comprising 24 males and 14 females. Isolated sino-maxillary involvement was observed in 32 cases (84.21%), and mandibular involvement in 5 cases (13.15%). No further disease progression was noted during the 2-year follow-up, based on clinical evaluation and postoperative computed tomography (CT) scans. Actinomycosis co-infection was identified in 21.05% of cases. Complications included wound dehiscence (39.47%), pus discharge (5.26%), reversible hearing impairment during HBO therapy (5.26%), and flap necrosis (2.63%). Four patients (10.52%) required sequential surgical debridement for sequestrum removal.

conclusionIt was concluded that concurrent use of oral posaconazole, adjunct HBO therapy and methylene blue prevents further progression of COVID-19 associated sino-maxillary and mandibular mucormycosis.

Indexed as

Antifungal AgentsCOVID-19Hyperbaric OxygenationMethylene BlueMucormycosisTriazolesAdultAgedCombined Modality TherapyDebridementFemaleHumansMaleMiddle AgedRetrospective StudiesYoung AdultAntifungal AgentsMethylene BlueposaconazoleTriazolesAntifungal agentsHyperbaric oxygenationMethylene blueMucormycosisOsteomyelitis

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.