الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Rhino-orbito-cerebral mucormycosis (ROCM) is a life-threatening acute angio-invasive fungal infection caused by Mucoraceae family in immunocompromised individuals. Fungal inoculation starts in the nose and paranasal sinuses and then infiltration of the surrounding bone and soft tissues when it reaches the orbit or the brain, fatal complications may follow. The management of ROCM needs a multi-disciplinary approach containing sino-nasal and orbital endoscopic debridement along with systemic antifungal drugs. when the orbit is severely affected, immediate orbital exenteration is a must to enhance the patient’s survival and limit the spread of the disease. Objective: The aim of this systematic review is to identify the effect of orbital exenteration in the management of orbital invasion in ROCM patients on the improvement of patient survival and prognosis. Patients and Method: Studies included are Retrospective observational and prospective studies conducted in the last 20 years. Participants included: Patients with ROCM fulfilling the clinical, radiological, and pathological/microbiological criteria for diagnosis with ROCM. Results: Orbital exenteration halts ROCM progression and Survival rates of orbital exenteration have been improved in last 20 years becoming as high as 84 % in our study. Also, the recovery time reduced to 45 days in this meta-analysis with a promising result in reconstructive surgeries for cosmetic and psychological efforts. Conclusion: Orbital exenteration together with medical treatment and sinus debridement control ROCM progression. Patients’ survival and recovery time enhance using this aggressive procedure. No guidelines are found concerning when the exenteration should be done. |