Role of medial orbital wall decompression in COVID-19-associated rhino-orbital mucormycosis management

Murthy, Ramesh; Bagchi, Aadhyaa; Gote, Yogita S

doi:10.4103/ijo.ijo_1294_21

Cited by 5 publications

(4 citation statements)

References 2 publications

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“…Murthy et al 19 suggested medial orbital wall decompression as a way to decrease intraorbital pressure in cases with ROCM. They tried it in 36 patients and none of them needed exenteration.…”

Section: Discussionmentioning

confidence: 99%

Exenterate or Not: A Simple Proposed Management Algorithm for Mucormycosis During the Era of COVID-19 in a Tertiary Eye Care Center in Egypt

Shabana

Eldesouky

Elbedewy

2022

OPTH

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Section: Discussionmentioning

confidence: 99%

Exenterate or Not: A Simple Proposed Management Algorithm for Mucormycosis During the Era of COVID-19 in a Tertiary Eye Care Center in Egypt

Shabana

Eldesouky

Elbedewy

2022

OPTH

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“…This converted the closed orbit into an open space and prevented compartment syndrome. Anterior orbitotomy and orbital debridement is a standard approach[ 3 7 ] and was performed whenever needed.…”

Section: Discussionmentioning

confidence: 99%

“…A surge in the cases of CAM was noted after the second wave of the pandemic in India. [ 1 2 ] The known treatment options were surgical debridement, transcutaneous retrobulbar amphotericin B (TRAMB) injections, systemic anti-fungal therapy, and exenteration,[ 3 4 5 ] and there were a few existing guidelines regarding treatment protocols. [ 6 7 ]…”

mentioning

confidence: 99%

Exploring the globe salvaging treatment options in patients of COVID-19-associated mucormycosis with orbital involvement

Khare

Chaurasia

Bhatnagar

2022

Indian J Ophthalmol

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Purpose: To explore the various globe salvaging treatment strategies for patients with coronavirus disease 2019-associated mucormycosis (CAM). Methods: This was a prospective interventional analytical study conducted at a Medical College in rural India. A total of 84 patients of CAM admitted between May 2021 and August 2021 were enrolled for the study. Patients with histologically proven CAM with clinical and/or radiological evidence of orbital involvement were divided into three treatment categories based on the site and extent of the lesion. Re-assessment was performed after 7 days. For patients who worsened with the primary approach, orbital exenteration was considered based on a Sion Hospital Scoring System. A novel approach to intra-orbital anti-fungal therapy, site-centered peri-bulbar injection of amphotericin B (SCPeriAmB), was also explored. All the patients were followed up for at least 3 months. Convenience sampling with descriptive statistics was used. Results: Six patients had to finally undergo exenteration by the end of the study period. The rest of the patients were reported to be stable or improved. No mortalities were reported on delaying the exenteration. No adverse events were noted in patients who were given SCPeriAmB. Conclusion: Globe salvaging treatment options should be advocated as a primary approach in patients with CAM. Site-centered peri-bulbar injections can be considered as an approach for delivering intra-orbital anti-fungal therapy in selected patients.

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“…Although orbital exenteration had been more frequently performed as the standard treatment in the past for periorbital tissue involvements, there have been numerous efforts to avoid disfiguring orbital exenteration, especially with localized orbital involvement to preserve vision and patient's mental health [27 ▪ ]. In addition to orbital exenteration, conservative surgical debridement with eyelid sparing, localized endoscopic orbital clearance, medial orbital wall decompression, local intraconal irrigation with AMB, surgical packing of the orbit and sinuses with AMB soaked gauze, and transcutaneous retrobulbar AMB (TRAMB) have been utilized to manage ROM [27 ▪ ,28,29]. TRAMB or sinus irrigation with AMB may be used after early, aggressive surgical debridement of paranasal sinuses with clean margins accompanied by turbinectomy, palatal resection, or medial orbital wall resection as needed [25 ▪ ,26 ▪▪ ].…”

Section: Managementmentioning

confidence: 99%

Rhino-orbital mucormycosis

Ryu

Laylani

Davila-Siliezar

et al. 2022

Current Opinion in Ophthalmology

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Purpose of reviewThe current article will update and review the clinical and radiological manifestations and management of rhino-orbital mucormycosis (ROM).Recent findingsThere has been an increase in cases of ROM worldwide, especially in India. Immunosuppression (especially diabetes mellitus) is a known predisposing risk factor for ROM. Delayed diagnosis and treatment of ROM can be vision or life-threatening. This article reviews the clinical and radiologic features, treatment, and prognosis of ROM with special emphasis on new and emerging therapies.SummaryROM is an angioinvasive fungal infection that affects the sinuses and orbits and may present to ophthalmologists. Clinicians should have a high index of suspicion for ROM, especially in patients with poorly controlled diabetes mellitus or other immunosuppression. Corticosteroid treatment (including the recent COVID-19 pandemic) may be a predisposing risk factor for ROM.

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Role of medial orbital wall decompression in COVID-19-associated rhino-orbital mucormycosis management

Cited by 5 publications

References 2 publications

Exenterate or Not: A Simple Proposed Management Algorithm for Mucormycosis During the Era of COVID-19 in a Tertiary Eye Care Center in Egypt

Exenterate or Not: A Simple Proposed Management Algorithm for Mucormycosis During the Era of COVID-19 in a Tertiary Eye Care Center in Egypt

Exploring the globe salvaging treatment options in patients of COVID-19-associated mucormycosis with orbital involvement

Rhino-orbital mucormycosis

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