Related Experiment Video
Updated: Sep 7, 2025
Nasal Brushing Sampling and Processing Using Digital High Speed Ciliary Videomicroscopy – Adaptation for the COVID-19 Pandemic
Published on: November 7, 2020
Exenterate or Not: A Simple Proposed Management Algorithm for Mucormycosis During the Era of COVID-19 in a Tertiary
Reham Refaat Shabana1, Mohamed Ashraf Eldesouky1, Hazem A Elbedewy1
1Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Gharbeya, Egypt.
Purpose:
To construct a simple management algorithm for cases with orbital mucormycosis during the COVID-19 era.
Methods:
Retrospective study included records of 30 Egyptian patients with post COVID-19 orbital mucormycosis. They underwent full clinical examination, laboratory investigations, Computed tomography (CT)/magnetic resonance imaging (MRI) of the paranasal sinuses and pathological specimen examination. The proposed algorithm was based on all the available data of the included patients.
Results:
The mean age of the studied patients was 62.47±11.13 years; 56.6% were females and 63.3% had uncontrolled diabetes mellitus. The main presentation was Orbital apex syndrome (OAS) in 43.3% of the cases. Twenty-six patients (86.6%) received systemic liposomal amphotericin B, while 4 patients (13.3%) received posaconazole. Orbital exenteration was done in 6 patients (20.0%), 4 of them died (66.7%). Twenty-four patients (80%) survived with clinical but not with visual improvement.
Conclusion:
Systemic antifungal treatment and functional endoscopic sinus surgery (FESS) with extensive debridement of involved necrotic tissues were the main steps to control ROCM. Orbital exenteration should be kept for cases with periorbital tissue affection as it did not increase the final cure rate. The proposed management algorithm is supposed to be simple and easy to follow.
