Vol. 5, Issue 2, Part A (2023)

Background: AIFR occurs secondary to the increased immunocompromised cases during COVID 19 pandemics. We aimed to study the CT and MRI findings in AIFR during COVID 19 pandemics.
Methods: A retrospective study was performed on 50 cases having the history of COVID 19 infection aged from 24 to 85 years old, both sexes, with AIFR and renal failure, poorly controlled type 1diabetes mellitus and malnutrition. All patients were subjected to CT scans, and MRI.
Results: Extra sinus soft tissue infiltration was pterygopalatine infiltration in 48 (96%) patients, anterior periantral fat and posterior periantral fat in 8 (16%) patients, nasolacrimal duct and lacrimal sac in 4 (8%) patients, orbital fat (medial/inferior) in 16 (32%) patients, nasal septal mucosal ulcer in 17 (34%) patients. Intracranial extension was subdual in 18 (36%) patients, epidural in 18 (36%) patients and brain parenchymal in 22 (44%) patients. vascular complications were venous thrombosis in 20 (40%) patients, arterial thrombosis in 1 (2%) patient and both arterial and venous thrombosis in 2 (4%) patients. Cavernous sinus involvement was in 23 (46%) patients, cranial nerve affection was in fourteen (28%) cases and bone dehiscence/abscess was in 22 (44%) patients.
Conclusions: CT and MRI results of AIFRS showed great variations starting from thickened mucosa of the paranasal sinuses, reaching orbital and intracranial extension with vascular thrombosis in addition to neuro-invasion. The distinctive mark inflammatory tissue infiltration into the pterygopalatine fossa and facial soft tissue might happen before the appearance of the mucosal disease.