Duration 5min, Q&A 3min
Isolated Involvement of Extraocular Muscles and Orbital Nerves by Fungal Granulomas of the Orbit
To highlight the special behavior of fungal granulomas of the orbit in exclusively growing along extraocular muscles and nerves of the orbit
One hundred and five cases of fungal granulomas of orbit treated over a period of 12 years.
Retrospective analysis of 105 cases of histopathology proven cases of fungal granulomas of orbit. The patients were diagnosed and treated at AlShifa Trust Eye Hospital, Rawalpindi, Pakistan over a period of 12 years (2001 2012). The patient record was analysed for patient demography and clinical data. The patient surgical record and histopathology reports were specially analysed to look for isolated involvement of extraocular muscles and orbital nerves.
Results and Conclusion
17% of orbital tumors in our series were fungal granulomas. Out of 105 cases of orbital fungal granulomas, 15 exclusively involved the extraocular muscles and nerves of the orbit, a prevalence of 14%. In all cases, the involvement was in the form of total and exclusive wrapping of muscles and nerves by the tumor. Twelve of these involved only the extraocular muscles, while three cases involved infraorbital nerve of the orbit. Out of twelve cases growing along the extraocular muscles, 7 involved the inferior rectus and 5 involved the medial rectus. All the fifteen patients were male with an average age of 25 years at the time of presentation (age range 5 to 40 years). The fungus identified in all these patients was Aspergillus fumigatus. In majority of patients, the underlying muscles or nerve was infiltrated by the fungal granuloma. Fungal granuloma of orbit has a special tendency to grow along extraocular muscles and infraorbital nerve. Proximity to sinuses and relatively thinner bony barrier are the main reasons of direct involvement of medial and inferior recti as well that of infrorbital nerve. Fungal tropism may play an important part in growing along the skeleton of extraocular muscles and infraorbital nerve.
[ Keyword ]
Orbital tumor / Fungal granuloma / Extraocular muscles
[ Conflict of Interest ]