{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:15:17Z","timestamp":1787004917158,"version":"build-2736575974"},"reference-count":12,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T00:00:00Z","timestamp":1737590400000},"content-version":"vor","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Introduction\u2003Mucormycosis is an aggressive, lethal fungal infection affecting the nasal and paranasal territory in immunocompromised patients. Orbital involvement is not uncommon and may require orbital exenteration.<\/jats:p>\n                  <jats:p>Objectives\u2003The management of orbital involvement in invasive fungal sinusitis is challenging, ranging from conservative retrobulbar amphotericin B injection in the early stages to orbital exenteration in late stages. Endoscopic endonasal debridement is a minimally invasive technique used to manage orbital fungal involvement in the late stages.<\/jats:p>\n                  <jats:p>Methods\u2003Endoscopic endonasal orbital clearance was performed to manage late-stage orbital invasive fungal infection (\u2265 stage 3c) or after failure of retrobulbar amphotericin B injection with no light perception. Removal of the lamina papyracea (LP) and incision of the periorbita were done to expose all the necrotic intraorbital content in the extra and intraconal spaces. A microdebrider was utilized to debride necrotic fungal infected tissue until a healthy vascularized plane was reached. Gelfoam (Pfizer Inc., New York, NY, United States) soaked in amphotericin B was applied as an adjunctive step to deliver antifungal medication to the orbital content.<\/jats:p>\n                  <jats:p>Results\u2003Fourteen patients were included in the study, 9 of whom were male and 5 female, with a mean age of 58.5 years. Eleven patients showed no evidence of disease progression (complete recovery and cessation of medical treatment). Two patients died 15 days after the surgery. The last patient developed frontal lobe abscess but has been treated with double antifungal medication.<\/jats:p>\n                  <jats:p>Conclusion\u2003Endoscopic endonasal orbital debridement could be an effective method to treat late-stage orbital fungal infection without jeopardizing the patient's life.<\/jats:p>\n                  <jats:p>Level of Evidence: 4.<\/jats:p>","DOI":"10.1055\/s-0044-1791645","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T18:57:47Z","timestamp":1737658667000},"page":"001-007","source":"Crossref","is-referenced-by-count":1,"title":["Endoscopic Orbital Clearance\/Debridement: A Potential Substitute for Orbital Exenteration in Rhino-orbital Mucormycosis"],"prefix":"10.1055","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4824-6734","authenticated-orcid":false,"given":"Ahmed Hassan","family":"Sweed","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Zagazig University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Mohammad","family":"Anany","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Zagazig University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atef","family":"Hussein","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, Zagazig University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed","family":"Nada","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, Zagazig University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Eesa","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Zagazig University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail","family":"Elnashar","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Zagazig University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Mobashir","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Zagazig University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enas Moustafa","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Faculty of Medicine, Zagazig University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Elsayed","family":"Elmaghawry","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Zagazig University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,1,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13907","article-title":"MRI as a road-map for surgical intervention of acute invasive fungal sinusitis in Covid-19 era","author":"A H Sweed","year":"2021","journal-title":"Clin Otolaryngol"},{"issue":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"e405","DOI":"10.1016\/S1473-3099(19)30312-3","article-title":"Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium","volume":"19","author":"O A Cornely","year":"2019","journal-title":"Lancet Infect Dis"},{"issue":"02","key":"ref3","doi-asserted-by":"publisher","first-page":"101238","DOI":"10.1016\/j.mycmed.2021.101238","article-title":"Surgical & medical management of ROCM (Rhino-orbito-cerebral mucormycosis) epidemic in COVID-19 era and its outcomes - 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