Horner's syndrome subsequent to minimally invasive video-assisted thyroidectomy in two patients

Abstract

Abstract. Horner's syndrome (HS), characterized by a combination of ptosis and miosis, is an uncommon complication of thyroid surgery, particularly in minimally invasive thyroid surgery. Two cases of HS were observed secondary to minimally invasive video-assisted thyroidectomy in the Department of Thyroid Breast Surgery of Zhejiang Provincial People's Hospital between August 2012 and July 2014. The two patients developed miosis and ptosis following total thyroidectomy; all symptoms had resolved at 1 and 11 months subsequent to surgery, respectively. HS has currently been reported secondary to numerous types of minimally invasive thyroid procedures. The literature was reviewed to identify cases of this iatrogenic complication secondary to each type of thyroidectomy and the possible injury mechanisms underlying the syndrome were summarized in the present study. In addition, factors that were associated with minimally invasive thyroidectomy, such as the limited endoscopic vision during the procedure, the retraction effect and the occurrence of thermal damage from the use of the harmonic scalpel, were emphasized. The present study concluded that close attention is required during minimally invasive thyroid surgery in order to avoid HS as a complication of the procedure.

Risk factors for the development of Horner’s syndrome following interscalene brachial plexus block using ropivacaine for shoulder arthroscopy: a randomised trial

“…It is characterized by miosis, ptosis, and anhidrosis, with or without enophthalmia. It may occur after a number of pathologies associated with the cervical region [1][2][3][4][5][6][7] or epidural [8], spinal anesthesia [9], as well as combined spinal-epidural anesthesia [10]. Despite the different techniques for blocking brachial plexus performed by the interscalene [11], transscalene [12], and sometimes, supraclavicular [13,14], and infraclavicular [15] local anaesthetics (LA), could still diffuse via the prevertebral spaces, block sympathetic nerves in the cervical region, as well as also spread to the sympathetic ganglia (the stellate ganglion), and could cause transient characteristic symptoms [16].…”

Horner’s Syndrome after Thyroidectomy: Two Cases Report

“…The most common mechanism of injury of the cervical sympathetic nerve is direct involvement of tumor of inflammation lesions, and the most common sites are prevertebral fascia, paratracheal area, posteromedial area of the carotid sheath, and lung apex [11]. Many studies have reported that Horner syndrome appeared after cervical surgery, but thyroid-surgery associated Horner syndrome is rare [12] [13]. In this report, we presented two typical Horner's syndrome after thyroid surgery.…”

Horner's syndrome in cervico-dorsal tuberculosis: A rare case report

“…Horner's syndrome, also known as Bernard-Horner syndrome, is characterized by miosis, ptosis, and apparent enophthalmos with or without anhidrosis. 2 This occurs due to affection of ipsi-lateral sympathetic trunk. 3 Horner's [ ( F i g .…”