The "Opercular" Approach to Orbital Reconstruction after Orbital Exenteration Following Rhino-Orbital-Cerebral Mucormycosis: A Novel Method.

Rhino-orbital cutaneous mucormycosis (ROCM) leading to orbital exenteration can be debilitating functionally as well as psychosocially. Orbital reconstruction following exenteration for mucormycosis has centered on volume filling with local, regional, or free flaps. This case series is built on the original idea of a bilayered operculum at the orbital inlet.  The opercular approach comprises an inner layer of hinged orbital mucosa and an outer layer of nasofacial flap in most cases, or alternatives, for lining or cover.  Eight cases of ROCM treated using the opercular approach are presented with satisfactory results and minimal complication. Four of the eight patients treated by this method remained free of complications after 1year.  This technique is simple, does not require microsurgical expertise, and is less time-consuming and less expensive.