Evaluation of a New Disease Staging System Using CT Scans to Measure Disease Severity in Rhinomaxillary Mucormycosis - An Analytical Study.

This study aims to evaluate reliability of Manekar et al. system in clinical settings by comparing and correlating it with widely used Lund & Mackay (L-M) system to quantify the severity of rhinomaxillary mucormycosis (RMM). Objectives are (a) To assess the severity of maxillary sinus disease using L-M system. (b) To assess the severity of maxillary sinus disease using Manekar et al. system. (c) To assess the severity of maxillary osteomyelitis using Manekar et al. system (d) To compare the scores of L-M and Manekar et al. system. This retrospective analytical study involved three experts reviewing CT scans of 38 RMM patients. Both Manekar et al. and L-M systems were used to grade the cases. Mean observations were calculated, and the systems were compared using Pearson's chi-squared test and Pearson correlation coefficient (PCC). The Kappa coefficient determined inter-rater reliability and variability. Kappa reliability test for Manekar et al. system showed values of k = 0.92 (left) and k = 0.94 (right), indicating perfect agreement. The correlation between Manekar et al. system and L-M system showed strong positive correlations, with PCC values of r = 0.832 (left) and r = 0.839 (right). A highly significant statistical difference was found between the two systems, as the L-M system assessed maxillary sinus involvement as a single unit, while the Manekar et al. system provided a detailed evaluation. The Manekar et al. system is reliable for evaluating maxillary sinus disease and osteomyelitis. Further research is needed to monitor disease progression and postoperative recovery using Manekar et al. system.