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Syndromes of the Orbital Apex, Superior Orbital Fissure, and Cavernous Sinus 

Syndromes of the Orbital Apex, Superior Orbital Fissure, and Cavernous Sinus
Chapter:
Syndromes of the Orbital Apex, Superior Orbital Fissure, and Cavernous Sinus
Author(s):

Matthew J. Thurtell

, and Robert L. Tomsak

DOI:
10.1093/med/9780190603953.003.0038
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date: 17 January 2021

Lesions in the orbital apex, superior orbital fissure, and cavernous sinus can give rise to characteristic combinations of cranial nerve palsies. In this chapter, we begin by reviewing the clinical features and common causes of syndromes of the orbital apex, superior orbital fissure, and cavernous sinus. We go on to discuss the pathogenesis and clinical features of rhino-orbital mucormycosis in detail, because it has a grave prognosis if it is not diagnosed and treated in a timely fashion. We then describe the roles and importance of imaging and tissue biopsy for its diagnosis. Lastly, we review the management of rhino-orbital mucormycosis, which includes rapid reversal of predisposing factors (such as diabetic ketoacidosis), immediate initiation of empiric antifungal treatment, and early surgical debridement of infected tissue.

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