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This abstract is assigned to session AOB Free Papers 2

Presentation type	Oral presentation
Title	Case presentation: Ramsay Hunt Syndrome in a patient with non-small cell lung cancer

Purpose	To report the complex presentation and management challenges of Ramsay Hunt Syndrome (RHS) in a patient with non-small cell lung cancer (NSCLC). The simultaneous occurrence of RHS and otitis externa in this patient highlights the need for a multidisciplinary treatment approach.
Methods	A 68-year-old female with NSCLC presented with a five-day history of left ear pain, which progressed to severe otorrhea, vesicular lesions, ear canal swelling, and left-sided facial paralysis (House-Brackmann III). Conductive hearing loss in the left ear was confirmed via the Weber test. Ophthalmic examination revealed lagophthalmos with absent Bell's phenomenon, leading to corneal epithelial defects.
Results	The patient was diagnosed with left-sided RHS, accompanied by perichondritis and otitis externa. Treatment with valacyclovir, corticosteroids, and antibiotics was initiated, along with Duratears® application (six times daily) and eyelid taping. During follow-up visits, worsening corneal dryness was noted, prompting an increase in Duratears® application and continuous patching.
Conclusion	NSCLC induces immunosuppression through the creation of an immunosuppressive tumor microenvironment, increasing susceptibility to infections like herpes zoster. Although RHS is rare, it can lead to severe complications, particularly in immunocompromised individuals. Early recognition and timely intervention, including antiviral therapy and corticosteroids, are crucial to minimize long-term complications such as synkinesis and postherpetic neuralgia, while managing corneal dryness and exposure keratopathy is essential for preserving vision.
Conflict of interest	No

Authors 1

Last name	SHERVINE
Initials	A

Authors 2

Last name	Ni Dhubhghaill
Initials	S