Cerebrospinal fluid leak from lateral orbit during exenteration for mucormycosis. Issue 9 (13th September 2020)

• Record Type: Journal Article
• Authors: Arora, Kanika; Mehta, Aditi; Virk, Ramandeep Singh; Saini, Manu
• Is Part Of: BMJ case reports. Volume 13:Issue 9(2020)
• Publication Date: 2020-09-13
• Subjects: ear -- nose and throat/otolaryngology -- infectious diseases -- ophthalmology -- oral and maxillofacial surgery -- otolaryngology / ENT; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2020-237575
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : 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.