Local Infiltration Anesthesia for Orbital Exenteration in Patients With Rhino-Orbital Cerebral Mucormycosis: A Case Series

Abstract

Orbital exenteration is occasionally required for rhino-orbital cerebral mucormycosis. Multiple associated comorbidities can pose a risk for general anesthesia. There is only 1 report of exenteration being performed under trigeminal nerve block. We describe 5 patients who underwent orbital exenteration under local infiltration anesthesia with sedation. Patients and surgeons reported satisfactory conditions, with stable hemodynamics and successful day care management. Orbital exenteration under local infiltration anesthesia can be a safe and effective alternative for patients with rhino-orbital mucormycosis who are at risk with use of general anesthesia.

Mucormycosis: update on clinical presentation, diagnosis, and treatment

“…Unfortunately, patients who would benefit from orbital exenteration may have underlying comorbidities precluding general anesthesia, leading to their not being surgical candidates. Veerabathula et al [80] described the use of local infiltration anesthesia as a possible alternative for such patients. Attempts are being made to avoid exenteration in patients with rhino-orbital MCR, opting for more cosmetically conservative procedures, such as eyelid-sparing debridement, endoscopic orbital clearance, and medial orbital wall decompression [81].…”

“…Veerabathula et al . [80] described the use of local infiltration anesthesia as a possible alternative for such patients. Attempts are being made to avoid exenteration in patients with rhino-orbital MCR, opting for more cosmetically conservative procedures, such as eyelid-sparing debridement, endoscopic orbital clearance, and medial orbital wall decompression [81].…”