ENDOSCOPIC or OPEN Surgery for this Sinus lesion ?

59yr old diabetic male presented with Left hemifacial pain & diplopia of 20 days duration. On examination-Left proptosis & infraorbital paraesthesia.

CT Scan – Irregular mass lesion in inferior aspect of Lt. Orbit with erosion of floor of Lt. Orbit & involvement of Lt. Maxillary sinus, Inferior rectus.

He was subjected to an Endoscopic biopsy through MMA, via which an incision using ball probe over infraorbital mucosa was made. Lesion was seen and biopsy was taken Submucosally using Navalakhe forceps (90o) which we suspected to be Aspergillus clinically. Hence we requested for special staining for detection of fungal sp.

HPE/ Silver Methenamine – Imp.: Invasive fungal lesion with Aspergillosis features.

Patient has been planned for Surgery. Follow up with treatment measures will be updated.