We describe an elderly diabetic patient presenting with sudden onset right-sided proptosis and vision loss secondary to rhino-orbital mucormycosis and central retinal vascular occlusion. He underwent orbital exenteration that was complicated by intraoperative cerebrospinal fluid (CSF) leak from lateral orbital wall. The leak was surgically repaired and the patient recovered well. We postulate the cause of the CSF leak to be twofold: necrotic periorbital tissue due to mucormycosis rendering the thin bones susceptible to damage and second, intraoperative manipulation and dissection at the orbital apex with monopolar cautery and instruments. We describe measures taken to successfully repair the CSF leak and the possible precautions that can be taken to avoid it.
- nose and throat/otolaryngology
- infectious diseases
- oral and maxillofacial surgery
- otolaryngology / ENT
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Contributors KA: patient management, conduct study, data acquisition and analysis, literature review, manuscript preparation and editing. AM: patient management, conduct study, data acquisition and analysis, manuscript preparation and editing. RSV: planning, reporting, concept and design, analysis of data, manuscript review and editing. MS: concept and design, analysis of data, manuscript review and editing.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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