Role of orbital exenteration in rhino-orbital-cerebral mucormycosis: Orbital exenteration in mucor “A BOON or A BANE”

Neetu Kori; Shiwani Chaturvedy; V. Bhaisare; Preeti Rawat; Shweta Walia; Manushree Gautam; Amit Shankhwar

doi:10.53730/ijhs.v6nS2.5615

Authors

Neetu Kori
dr.neetulife@gmail.com
Associate Professor, Department of Ophthalmology, MGM Medical College, Indore, M.P
Shiwani Chaturvedy RSO, Department of Ophthalmology, MGM Medical College, Indore, M.P
V. Bhaisare Professor, Department of Ophthalmology, MGM Medical College, Indore, M.P
Preeti Rawat Professor, Department of Ophthalmology, MGM Medical College, Indore, M.P
Shweta Walia Professor, Department of Ophthalmology, MGM Medical College, Indore, M.P
Manushree Gautam Assistant professor, Department of Ophthalmology, MGM Medical College, Indore, M.P
Amit Shankhwar Associate Professor, Department of Radiodiagnosis, MGM Medical College, Indore, M.P

Keywords:

ROCM, TRAMB, orbital exenteration, intracranial extension, SION scoring

Abstract

Purpose–Mucormycosis is an uncommon, rapidly progressive, commonly fatal, opportunistic serious fungal infection.The high mortality rate highlights the importance of early detection and treatment. The purpose of this study to determine theoutcome of orbital exenteration in Rhino-orbital-cerebral mucormycosis(ROCM) patients. Methods and materials–This study includesall proven ROCM patients who had underwent orbital exenteration based on SION Scoring system from 1^st may 2021 to 30 june 2021 in MYH hospital, Indore.Those patients were reviewedand the outcome of orbital exenterationwas analysed. Results- Total 29ROCM patients were underwent for orbital exenteration based on SION Scoring system. 19(65.5 %)out of 29 patients had intracranial extension and 10 (34.480%) did not have intracranial extension.

Out of 29, 6 (20.68%) patients hadsuccumbed to death within 10 days of orbital exenteration was having bilateral orbital involvement with intracranial extension.23(79.34%) patientshave favorable outcome with regular follow up. Conclusion- Survival of mucormycosis patients depends on the their good glycemic control,immune status, laterality of the orbital involvement and early detection of intracranial extensionof the disease.With prompt medical (high dose intravenous amphotericin B) and early aggressive surgical intervention involving FESS and orbital exenteration can preventintracranial extension and may improve survival rate .Intracranial extension of the disease has invariably been associated with high mortality.

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