Horner syndrome: tribute to Professor Horner on his 190th birthday

Objectives Horner syndrome (HS) is a rare complication of thyroid surgery. However, the relationship between the occurrence of HS and thyroid upper pole injury is still not completely clear, and there are only few reports. Case presentation A 24-year-old female underwent endoscopic thyroidectomy for thyroid papillary carcinoma. The intraoperative examination found that the upper pole of the thyroid was bleeding. During hemostasis, the ultrasonic knife consciously peeled too deep and stopped. The patient developed HS immediately after operation. We analyzed the association between deep dissection of the upper thyroid pole and an increase in the HS incidence rate through literature searches and anatomical relationships. Conclusions Our case report discussed the potential relationship between the degree of thyroid upper pole dissection and the occurrence of HS in routine thyroid surgery, and provided a warning for the degree of thyroid upper pole dissection in the clinic to avoid HS.

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Diagnosis and treatment of HS after endoscopic thyroid surgery: case report and brief literature review

Deng,

Ding

2023

Front. Surg.

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BackgroundHorner’s syndrome (HS) is a rare condition due to damage to the 3-neuron sympathetic pathway anywhere between the posterior-lateral nuclei of the hypothalamus and the oculosympathetic fiber, particularly as a post-thyroidectomy symptom. In this case report, we present a case of HS following endoscopic thyroid surgery (ETS) and briefly review the literature.Case reportDuring a routine physical examination, a 29-year-old female patient was incidentally found to have multiple nodules in the right thyroid. She was subsequently admitted to the Department of General Surgery for further examinations and treatment. A fine-needle aspiration biopsy confirmed malignancy in these nodules. As a result, the patient underwent radical resection of the right thyroid and ipsilateral central lymph node dissection using endoscopy. Pathological diagnosis revealed papillary thyroid carcinoma. Unexpectedly, on the third day after the operation, the patient was diagnosed with Horner’s syndrome based on the presence of miosis and ptosis. After 1 week of follow-up, the symptoms related to HS significantly improved.ConclusionHorner’s syndrome is an uncommon complication of thyroidectomy in patients undergoing ETS. Therefore, it is crucial to perform careful operations and minimize iatrogenic surgical damage to reduce the incidence of HS. This case serves as a reminder that making rational judgments and implementing appropriate measures are essential for achieving a favorable prognosis and preserving facial esthetics.

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Horner syndrome: tribute to Professor Horner on his 190th birthday

Cited by 3 publications

References 6 publications

Horner syndrome after thyroid-related surgery: a review

Horner syndrome after thyroid-related surgery: a review

Horner syndrome immediately after deep dissection of upper thyroid pole: a case report and review of the literature

Diagnosis and treatment of HS after endoscopic thyroid surgery: case report and brief literature review

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