Purpose: To propose a surgical staging system with management protocol for post-covid Rhino-orbito-cerebral Mucormycosis (ROCM) with central skull base osteomyelitis Methods: A prospective cohort study of post-covid ROCM patients in a tertiary centre between May 2021 and January 2022. Patients were assessed radiologically and staged from I to V. They were followed up for a period of 8 to 18 months and surgical outcome was assessed. Results: Total of 193 patients (129 primary and 64 revision). Maxilla was found to be the epicenter of anterior disease (69.3%) and pterygoid wedge, the epicenter of posterior disease (85.6%). More than 65% of our patients, at the time of presentation, presented with ROCM with involvement of the central skull base. Intracranial disease was noted in 46.5% of patients. The mortality rate was 6.2 %. Conclusion: This staging system provides a systematic protocol for the management of ROCM, with emphasis on meticulous clearance of central skull base.

The authors have declared no competing interest.

This study did not receive any funding

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Institutional Ethics Committee of Royal Pearl Hospital Trichy. Reg.No.ECR/1325/Inst/TN/2021

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