LAGOPHTHALMOS: HOW THE NMRRC HELPS PATIENTS DEAL WITH COMPLICATIONS AFTER THE MAIN TREATMENT

In the microsurgical department of the P. Hertsen Moscow Oncology Research Institute – branch of the Federal State Budgetary Institution of the “National Medical Research Radiological Centre” of the Ministry of Health of the Russian Federation performed reconstructive plastic surgery to restore the upper eyelid, strengthen the lower eyelid and soft tissues of the infraorbital region.

Yuriy, a 44-year-old young man from the Volgograd region, felt pain in the neck and the appearance of nodules there back in February 2024. He independently contacted the P. Hertsen Moscow Oncology Research Institute, where after a comprehensive examination the patient was diagnosed with cancer of the right parotid salivary gland. In the microsurgical department, he underwent a radical parotidectomy, which is complete removal of the parotid salivary gland, and lymphadenectomy on the neck.

However, after completion of surgical treatment, as often happens in this cohort of patients, paralysis of the branches of the facial nerve developed, which is characterized by weakness of the facial muscles and lagophthalmos – incomplete closure of the eyeball by the eyelids. “Such consequences as a result of radical removal of a malignant tumor on the face can occur, and they are always discussed with the patient at the preoperative stage,” explains the head of the department of oncoplastic surgery at the P. Hertsen Moscow Oncology Research Institute Professor Dmitry Viktorovich Davydov.

After surgical treatment, such patients are prescribed local therapy, including the prescription of tear substitutes, and then, if necessary, reconstructive microsurgical intervention on the eyelids is performed.

“Why is this condition dangerous? When the eyeball does not close completely, the patient may develop drying of the cornea keratopathy and infectious processes, including the formation of ulcers in the cornea and even loss of visual functions, explains Dmitry Viktorovich. To prevent it, it is necessary to perform an operation to weight the upper eyelid to increase its weight and thereby achieve complete closure. Also the lower eyelid is also restored for supporting function, in order to improve the fit of the eyelid to the surface of the eyeball, and maintain the shape and tone of the eyelid as much as possible.”

It is curious that plastic surgeons use skin from the patient’s behind-the-ear area as a graft, the color of which over time will completely match the color of the skin on the patient’s eyelid. For several days after the operation, the patient is in a special bandage, and then, after the sutures are removed, after about a few weeks, the mobility of the operated eyelid is completely restored, which will be no different from a healthy one.