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Rhino-orbito-cerebral mucormycosis. Management strategies to avoid or limit intracraneal affection and improve
Olga Plowes Hernández1, Héctor M Prado Calleros1, Galo Santiago Soberón Marmissolle Daguerre1
1División de Otorrinolaringología y Cirugía de Cabeza y Cuello, Hospital General «Dr. Manuel Gea González», México DF, México.
Abstract:
Mucormycosis is a rare opportunistic infection. The aim of the study was to review the cases presented in our department with rhino-orbital mucormycosis and to describe the clinical protocol, diagnosis and therapy used in these patients. We conducted a retrospective, longitudinal, descriptive study, in which we evaluated the records of patients with rhino-orbital mucormycosis in the period from January to October 2013. We found 5 cases. Pterigomaxillary fossa disease was found in 100% of our patients. Medical and surgical treatment performed early by extensive endoscopic debridement (including debridement and resection of pterygomaxillary fossa) and orbital exenteration in patients presenting with orbitary apex syndrome in conjunction with the ophthalmology department of our hospital, with excellent results in the survival of our patients (all patients survived).
Insights
This study reviews 5 cases of rhino-orbital mucormycosis, highlighting pterygomaxillary fossa involvement. Early aggressive surgical and medical treatment led to excellent patient survival rates.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Otorhinolaryngology
Background:
- Mucormycosis is a rare, life-threatening opportunistic fungal infection.
- Rhino-orbital mucormycosis presents a significant diagnostic and therapeutic challenge.
Purpose of the Study:
- To review rhino-orbital mucormycosis cases managed at our institution.
- To describe the diagnostic and therapeutic protocols employed.
- To evaluate treatment outcomes and patient survival.
Main Methods:
- Retrospective, longitudinal, descriptive study of 5 patients diagnosed with rhino-orbital mucormycosis between January and October 2013.
- Evaluation of medical records, clinical presentation, diagnostic procedures, and treatment strategies.
- Surgical intervention included extensive endoscopic debridement and, when necessary, orbital exenteration.
Main Results:
- Pterygomaxillary fossa involvement was observed in 100% of the cases.
- All patients received early medical and surgical treatment.
- Comprehensive treatment, including pterygomaxillary fossa debridement and orbital exenteration for orbital apex syndrome, resulted in complete survival.
Conclusions:
- Early and aggressive multidisciplinary management is crucial for successful rhino-orbital mucormycosis treatment.
- Extensive endoscopic debridement and orbital exenteration are effective surgical strategies.
- Prompt intervention significantly improves survival outcomes in patients with rhino-orbital mucormycosis.
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