Management of Limited Rhino-orbital Mucormycosis without Exenteration

Abstract

Eight cases of rhino-orbital mucormycosis managed successfully without exenteration were reviewed. The favorable outcome was attributable to early diagnosis and management of focal areas of fungus infection. Treatment included: (1) correction of diabetic ketoacidosis or other concomitant metabolic derangement; (2) wide local excision and debridement of all involved and devitalized oral, nasal, sinus, and orbital tissue, while establishing adequate sinus and orbital drainage; (3) daily irrigation and packing of the involved orbital and paranasal areas with amphotericin B; and (4) intravenous amphotericin B. This represents the largest reported series of rhino-orbital mucormycosis survivors without mutilating surgery and with unaltered visual acuity.