International Journal of Otorhinolaryngology and Head and Neck Surgery | October 2020 | Vol 6 | Issue 10 Page 1923 International Journal of Otorhinolaryngology and Head and Neck Surgery Munjal M et al. Int J Otorhinolaryngol Head Neck Surg. 2020 Oct;6(10):1923-1926 http://www.ijorl.com pISSN 2454-5929 | eISSN 2454-5937 Case Report Occuloplastic intervention in mycosis Manish Munjal 1* , Porshia Rishi 1 , Nitika Tuli 1 , Harjinder Singh 1 , Ojassvi Rishi 1 , Shubham Munjal 2 , Tej Mehar 2 INTRODUCTION Primary cutaneous mycoses are rare entity to be seen in immuno competent patients especially in the rhino facial region. 1 Cutaneous aspergillosis is either primary or secondary, primary occurring from direct inoculation post trauma and secondary from disseminated aspergillosis. 2 Spore inhalation results in sinus disease and subcutaneous infection which eventually progress to involve paranasal sinuses and soft tissue of the face. The common species responsible for cutaneous aspergillosis are A. fumigates, A. niger, A. flavus, A. ustus. 3,4 Diagnosis is based on histopathology with the identification of the hyphae of Aspergillus spp. which are 3-4 mm in diameter, septate and branch at acute angles. 5 We present a rare case report in which surgical intervention was undertaken in the vicinity of the eye where temporal vision was getting affected due to a mass adherent to the orbital fascia. CASE REPORT A 53-year male patient presented with a 3 x 2 cm swelling on the left infraorbital margin and extending till the lateral canthus for 8 months (Figure 1). There was no history of nasal obstruction, discharge, bleed or infraorbital paraesthesia. There was no history of hypertension, diabetes mellitus, steroid intake or any disease or condition leading to immune compromised state or trauma or surgical procedure over the cheek and infraorbital region. Nasal endoscopy was normal and no discharge was noted in the middle meatus. The swelling was non tender, circumscribed with stretched overlying skin. Local temperature was similar ABSTRACT Mycosis of the paranasal sinuses with an indolent course is usually noted in the immunocompetent and the likely species is usually aspergillosis. The fungus is predominantly seen in the maxillary sinus. It encroaches into its vicinity either by contiguous spread or as a skip lesion, with a normal tissue in between. Imaging studies, CT or MRI clinches the diagnosis. Laterally the infratemporal fossa and superiorly the orbit are the regions of concern. Progressive cheek paresthesia and restricted eye movements and field of vision are the clinical presentations in such a scenario. Oral antifungals “the imidazoles” though are quite effective but often a surgical intervention is called for, other than for the purpose of a biopsy. Oculoplastic intervention was undertaken in one patient. Keywords: Aspergillosis, Subcutaneous mass, Orbit 1 Department of ENT- Head and Neck Surgery, 2 Department of Physiology, Dayanand Medical College, Ludhiana, Punjab, India Received: 28 July 2020 Revised: 06 September 2020 Accepted: 09 September 2020 *Correspondence: Dr. Manish Munjal, E-mail: manishmunjaldr@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20204205