Bilateral Ophthalmoplegia After Neoadjuvant Pembrolizumab for Oral Cavity Squamous Cell Carcinoma.

Estephan, Leonard E; Jacoby, Peter; Cognetti, David M; Manobianco, Steven A · Laryngoscope · 2026

case_report · Level V

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Abstract

The role of immune checkpoint inhibition (ICI) therapy in the treatment of head and neck squamous cell carcinoma (HNSCC) is expanding with increased utilization of neoadjuvant and adjuvant pembrolizumab in the setting of locally advanced disease. This report describes the presentation and management of the first known case of pembrolizumab-induced isolated bilateral ophthalmoplegia in a patient with locally advanced oral cavity squamous cell carcinoma. Multidisciplinary teams, including head and neck surgeons, are integral to the management of treatment-related complications following ICI therapy, and comprehensive guidelines are necessary optimize outcomes for patients with HNSCC.