Purpose Cavernous sinus thrombosis (CST) is a complication of rhino-orbital-cerebral mucormycosis. The COVID-19 pandemic saw a rapid surge in the cases of acute fungal sinusitis, many of whom also had CST, further contributing to the ophthalmoplegia. This study was a retrospective audit of patients with mucormycosis treated during the first wave of the COVID-19 pandemic.Methods This study was conducted at a tertiary referral centre, and patients with rhino-orbital mucormycosis were included. Relevant laboratory investigations and CT scans of the paranasal sinuses and the cavernous sinus were analysed. Mortality at discharge was calculated.Results 61 cases of invasive mucormycosis were seen, of whom 20 were COVID-19 positive, and 21 had radiological evidence of CST. All patients in the study initially presented with clinical suspicion of mucormycosis, and COVID-19 was diagnosed during pre-admission investigations. 93% of patients had diabetes. A majority of patients received Amphotericin B and surgical debridement. The sphenoid sinus was involved in 32(52%) patients and the orbit in 34(56%). Factors affecting CST, such as platelet counts, were studied. Fifteen (25%) patients succumbed during their treatment.Conclusions 34.4% of patients with mucormycosis developed CST. Being COVID-19 positive led to an increase in mortality; however, there was no significant increase in death due to simultaneous COVID-19 and CST. Sinus involvement was not significant for the development of CST.

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Background Orbital pseudolymphoma is one of the rare diseases affecting the ocular adnexa and causing various symptoms requiring histopathological evidence for diagnosis and appropriate treatment with oral steroids or immunosuppressive agents. However, there is less literature available on this disease, thus adding to it will help in the early diagnosis and treatment of the patients. Case presentation A 48-year-old female from a village in South India came to our tertiary care centre with the only complaints of right eye protrusion for 1 year. With a working diagnosis of intraorbital mass, radiological investigations like contrast-enhanced CT and MRI were taken. It showed well-capsulated mass involving the right inferior rectus extending into the intraconal space just abutting the optic nerve. Trans-antral endoscopic biopsy under general anaesthesia was taken and reported as pseudolymphoma proven with CD 3 and CD 20 immunohistochemistry markers. The patient was treated with oral corticosteroids and tapered over a period of 3 months. During the treatment period, the patient developed no diminution of vision or new complaints. Conclusion Orbital pseudolymphomas are benign lymphoproliferative diseases affecting the ocular adnexal tissue. Patients can present with painless ptosis, proptosis, diplopia, or eyelid swelling. Prompt diagnosis and treatment result in the remission of the disease.

The following is a case report of an adolescent with mental retardation who had congenital aural atresia with contralateral congenital facial palsy. She developed multiple intracranial complications (cerebellar abscess and lateral sinus thrombosis) due to cholesteatoma. We managed her in a multidisciplinary approach. This report discusses case management, emphasising the meticulous intraoperative steps taken in identifying the landmarks and precautions adopted to avoid postoperative facial palsy and other complications.

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