Anesthetic Management of Rhinoorbitocerebral Mucormycosis; Focus on Challenges

This study aimed to evaluate the anesthetic management of patients undergoing surgical resection for rhino-orbito-cerebral mucormycosis (ROC).The study evaluated 12 patients that underwent surgical resection for ROC mucormycosis under general anesthesia. Demographic characteristics, hemodynamic parameters, invasive monitoring methods, surgical procedures, hospital records, and mortality rates were reviewed for each patient.The patients had a median age of 58 (range, 5-86) years. Two patients had an American Society of Anesthesiologists (ASA) score of II while the remaining 10 patients had a score of III. Eleven (91.7%) patients had a diagnosis of rhino-orbital mucormycosis and 1 (8.3%) patient was diagnosed with ROC mucormycosis. Most common comorbidity was DM (n=8), followed by hematological malignancy (n=4), solid organ malignancy (n=3), and kidney transplantation (n=2). Invasive arterial monitoring was performed in 7 and central venous cannulation was performed in 5 patients. Six patients were transferred to the intensive care unit (ICU) and the mortality rate was 25% with an average mortality time waso 7 days in 3 cases.In cases of ROC mucormycosis, necessary precautions should be taken for the difficult airway caused by fungal debris in the oropharyngeal region and supraglottic edema. Postoperative ICU is important due to comorbidities and fungal infection with high mortality.
Source: Journal of Medical Mycology - Category: Biology Source Type: research