Rhino-orbito-cerebral mucormycosis. Management strategies to avoid or limit intracraneal affection and improve survival

• Published in: Acta otorrinolaringologica espanola Vol. 66; no. 6; p. 348
• Main Authors: Plowes Hernández, Olga, Prado Calleros, Héctor M, Soberón Marmissolle Daguerre, Galo Santiago, Sadek González, Andrés
• Format: Journal Article
• Language: English
• Published: Spain 01.11.2015
• Subjects: Amphotericin B - therapeutic use; Antifungal Agents - therapeutic use; Cavernous Sinus Thrombosis - etiology; Combined Modality Therapy; Debridement; Diabetes Mellitus, Type 2 - complications; Disease Management; Encephalitis - diagnostic imaging; Encephalitis - etiology; Encephalitis - microbiology; Encephalitis - prevention & control; Encephalitis - therapy; Endoscopy; Facial Paralysis - etiology; Female; Humans; Hypesthesia - etiology; Immunocompromised Host; Magnetic Resonance Imaging; Male; Middle Aged; Mucormycosis - complications; Mucormycosis - diagnostic imaging; Mucormycosis - therapy; Nasal Obstruction - etiology; Orbital Diseases - diagnostic imaging; Orbital Diseases - etiology; Orbital Diseases - microbiology; Orbital Diseases - therapy; Rhinitis - diagnostic imaging; Rhinitis - etiology; Rhinitis - microbiology; Rhinitis - therapy; Tomography, X-Ray Computed; Rinosinusitis micótica invasiva; Rhino-orbito-cerebral mucormycosis; Invasive fungal rhinosinusitis; Mucormicosis rino-orbito-cerebral
• ISSN: 1988-3013
• DOI: 10.1016/j.otorri.2015.01.007

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).