Post-Parotidectomy Eyelid Edema and Ptosis: Anatomical Insights of an Unusual Clinical Presentation
Author: Pedro Cardoso Teixeira
Base Hospital / Institution: Unidade Local de Saúde Entre Douro e Vouga
ePoster presentation
Abstract ID: 24-527
Purpose
Ptosis poses significant challenges for patients, particularly when caused by mechanical factors, as observed in conditions like blepharochalasis, palpebral tumors, or eyelid edema. To date, the occurrence of upper eyelid edema following parotidectomy has not been described in the literature. This case report aims to underscore the importance of recognizing lymphatic drainage impairment as a potential consequence of parotidectomy and exploring a surgical approach for resultant unilateral ptosis.
Methods
A retrospective analysis of a patient’s medical records presenting with left ptosis was conducted. Clinical assessments, ancillary tests, anatomopathological examinations, surgical interventions, and follow-up data were retrieved to provide insights into this rare complication.
Results
This case reports a 62-year-old male patient with eyelid edema following a left total parotidectomy for parotid secretory carcinoma. Ophthalmological examination revealed left upper eyelid edema causing unilateral mechanical ptosis and significant ocular discomfort. It was hypothesized that the excision of a lymph node during parotidectomy possibly disrupted lymphatic drainage of the eyelids. Initial conservative treatments failed to alleviate symptoms, leading to left eye blepharoptosis repair surgery. Surgical exploration revealed extrusion of lymphatic fluid during the excision of upper lid skin. After surgery, the patient exhibited complete resolution of lymphedema and ptosis with satisfactory cosmetic and functional outcomes.
Conclusion
Parotid lymph nodes play a crucial role in eyelid lymphatic drainage, and their removal can cause eyelid lymphedema, ultimately resulting in ptosis. Unilateral blepharoptosis repair surgery emerged as an effective intervention to address mechanical ptosis and improve patient’s quality of life. It is important to consider the disruption of palpebral lymphatic drainage as a complication, albeit rare, of parotidectomy in order to enhance early diagnosis and accurate management of these patients.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| João | Alves Ambrósio | Unidade Local de Saúde Entre Douro e Vouga |
| Catarina | Pestana Aguiar | Unidade Local de Saúde Entre Douro e Vouga |
| João | Chibante | Unidade Local de Saúde Entre Douro e Vouga |
| João | Carlos Costa | Unidade Local de Saúde Entre Douro e Vouga |
