MGM Healthcare, a super-specialty hospital in Chennai, on Wednesday announced that it has successfully conducted an emergency endoscopic transnasal orbital surgery to treat a 68-year-old female COVID-19-infected patient who got seriously affected with black fungus or mucormycosis. The patient was being treated for COVID pneumonia with systemic steroids and oxygen supplementation for the past two weeks. She reported a persistent headache on her right side and blood-tinged nasal discharge along with drooping of right eyelid recently. She was then shifted to MGM Healthcare for further treatment and clinical examination at the hospital revealed extremely tender right side of face with painful restricted eye movements and inability to open the right eye.
The patient was immunocompetent but had elevated blood sugar levels during the course of treatment. ENT surgeons at the MGM Healthcare then performed a diagnostic nasal endoscopy which showed blackish nasal mucosa in patches and gave rise to the clinical suspicion of mucormycosis which was further confirmed by histopathology. Radiological investigations revealed invasive fungal disease limited to the right naso-orbital region involving frontal and ethmoid sinuses.
“After a thorough surgical planning, a modified endoscopic transnasal surgical approach was adopted to reach the anatomical areas affected by the disease, explained Professor Dr Sanjeev Mohanty, Senior Consultant and Head, Institute of ENT, Head & Neck Surgery. He added that the transorbital surgery in this case entailed the use of multiple angled high-definition endoscopes and appropriate instruments which are important to obtain the required degree of precision and key to a successful outcome.
In this case, time was of primary essence as black fungus (mucormycosis) had invaded the para nasal sinuses and orbit of the patient. Through this emergency endoscopic surgery, it helped to mitigate the spread of the deadly fungus and remove the dead tissues with a course of anti-fungal therapy for optimum cure simultaneously. MGM Healthcare used collective inputs from all allied clinical disciplines and relied on evidence based methodology to help the patient get back on her feet and go on to pursue a normal life.
The painful symptoms experienced by the patient have been alleviated post-surgery and doctors confirmed that her vision is intact along with the resolving of drooping eyelid (ptosis) of the right eye. She is being monitored continually and has been administered with anti-fungal therapy to prevent any relapse during the post-COVID recovery period.