Extra Orbital Periocular Tuberculosis - A Rare Case Report.

Tuberculosis is a known bacterial infection caused by Mycobacterium tuberculosis complex and has varied clinical presentation. Though pulmonary from is the commonest, extra orbital form is a rare presentation of the same. Here we present a case of extra orbital tuberculosis in a young female, presenting as a painless swelling lateral to the lateral canthus of right eye, along with right preauricular lymphadenopathy. The mass was excised, sent for histopathological examination and culture of M. tuberculosis, which yielded positive results.

Clinical outcome of orbital apex syndrome in COVID associated mucormycosis patients in a tertiary care hospital.

AIM: To share clinical pattern of presentation, the modalities of surgical intervention and the one month post-surgical outcome of rhino-orbito-mucormycosis (ROCM) cases. METHODS: All COVID associated mucormycosis (CAM) patients underwent comprehensive multidisciplinary examination by ophthalmologist, otorhinolaryngologist and physician. Patients with clinical and radiological evidence of orbital apex involvement were included in the study. Appropriate medical and surgical intervention were done to each patient. Patients were followed up one-month post intervention. RESULTS: Out of 89 CAM patients, 31 (34.8%) had orbital apex syndrome. Sixty-six (74.2%) of such patients had pre-existing diabetes mellitus, 18 (58%) patients had prior documented use of steroid use, and 55 (61.8%) had no light perception (LP) presenting vision. Blepharoptosis, proptosis, complete ophthalmoplegia were common clinical findings. Seventeen (19.1%) of such patients had variable amount of cavernous sinus involvement. Endoscopic debridement of paranasal sinuses and orbit with or without eyelid sparing limited orbital exenteration was done in most cases, 34 (38.2%) patients could retain vision in the affected eye. CONCLUSION: Orbital apex involvement in CAM patients occur very fast. It not only leads to loss of vision but also sacrifice of the eyeball, orbital contents and eyelids. Early diagnosis and prompt intervention can preserve life, vision and spare mutilating surgeries.

Surgical management of bilateral abductor paralysis by extralaryngeal approach.

Paralysis of the abductors of both vocal cords causes the vocal cords to lie in the midline or paramedian position. This compromises the airways and causes respiratory distress which may often be acute necessitating tracheostomy. A lateralisation of the vocal cord is required to provide adequate airway without significantly affecting speech. Extralaryngeal approach is our preferred approach. This article reports a study of eight cases who underwent arytenoid abduction by an extralaryngeal approach for bilateral abductor paralysis of vocal cords.