Horner’s syndrome: an unusual complication of thyroidectomy: a case report

Seneviratne, Sanjeewa; Kumara, Dewamuni S.; Drahaman, A. M. P.

doi:10.1186/s13256-016-1072-7

Cited by 15 publications

(18 citation statements)

References 5 publications

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“…Horner’s syndrome has also been found to be a rare complication following thyroidectomy. Theories of pathophysiology include ischaemia induced nerve damage after ligating the inferior thyroid vessels, and from local trauma to the sympathetic chain during lateral retraction or identification of the recurrent laryngeal nerve 13. It is important to be aware of all anatomical structures around you when operating to minimise the risk iatrogenic injury.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Horner’s syndrome following excision of incidental cervical ganglioneuroma during hemithyroidectomy and parathyroid gland exploration

McCrory¹,

Kelly

Korda

2020

BMJ Case Rep

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This 49-year-old woman was referred to ear, nose and throat (ENT) with primary hyperparathyroidism. Imaging studies failed to localise the adenoma so she required four-gland parathyroid exploration. She also required diagnostic left hemithyroidectomy as she had a U3 nodule with multiple insufficient fine needle aspirations (FNAs). Intraoperatively, the left thyroidectomy proceeded uneventfully. No convincing left inferior parathyroid gland was identified however palpation revealed a 1 cm mass just medial to carotid artery. This was excised as probable ectopic parathyroid gland. She was discharged two days later. Thirteen days postoperatively she attended Eye Casualty with a left-sided Horner’s syndrome. A CT angio of aortic arch was normal. She was reviewed at ENT outpatients. Histopathology report of the expected ectopic parathyroid gland returned as benign ganglioneuroma, likely arising from her left sympathetic chain. Horner’s syndrome is a common side effect from excision of ganglioneuromas, but an incredibly rare side effect from thyroid or parathyroid surgery.

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Section: Discussionmentioning

confidence: 99%

Postoperative Horner’s syndrome following excision of incidental cervical ganglioneuroma during hemithyroidectomy and parathyroid gland exploration

McCrory¹,

Kelly

Korda

2020

BMJ Case Rep

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“…This close and, more importantly, variable anatomical relationship makes the sympathetic trunk and the middle cervical ganglion highly susceptible during thyroidectomy. [ 7 ] In addition, the inferior thyroid artery has been reported to supply the sympathetic chain, which can be affected due to ligation of this artery. [ 6 ] Heat injury induced by the ultrasonic scalpel: In our report, the operation was performed with an ultrasonic scalpel.…”

Section: Discussionmentioning

confidence: 99%

“…[ 2 , 3 ] Although it is an unusual complication of thyroidectomy due to improvements in surgical techniques, HS is inevitable because of the close and highly variable anatomical relationship between the thyroid gland and cervical sympathetic trunk. [ 4 – 7 ] Here, we report a case of HS in a patient with Graves disease associated with papillary thyroid carcinoma who underwent left-side thyroidectomy and neck dissection.…”

Section: Introductionmentioning

confidence: 99%

Horner syndrome as a postoperative complication after minimally invasive video-assisted thyroidectomy

Zhang²,

Gan³

et al. 2017

Medicine

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Rationale:Horner syndrome is an unusual complication after thyroidectomy.Patient concerns:We report a case of Horner syndrome in a 34-year-old female patient with Graves disease associated with papillary thyroid carcinoma who underwent left-side minimally invasive video-assisted thyroidectomy and neck dissection.Diagnosis:Horner syndrome was diagnosed based on left myosis, eyelid ptosis, and mild enophthalmos, which developed in the patient on postoperative day 2.Interventions:The patient was administered glucocorticoids and neurotrophic drugs on postoperative day 3.Outcome:The symptoms of Horner syndrome were significantly relieved 1 year later.Lessons:Surgeons must be aware that Horner syndrome may be a source of iatrogenic complications, and patients also should be informed of these complications before surgery.

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“…The clinical characteristics of the cases are summarized in Table 2 [4,6,7,14,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Among these patients, the patients with HS most commonly underwent TT with lymph node dissection, especially with lateral lymph node dissection (LLND) [4,6,7,14,20,[23][24][25][26][28][29][30]. In general, HS is not very difficult to diagnose in patients with a recent history of head or neck surgery and obvious symptoms during the postoperative hospital stay.…”

Section: Neuroanatomy and Etiology Of Hsmentioning

confidence: 99%

Case report and literature review: Horner syndrome subsequent to endoscopic thyroid surgery

et al. 2021

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Background Horner syndrome (HS), mainly characterized by symptoms including ptosis, miosis, and anhidrosis on the affected face, is a condition that is well documented but rarely reported as a postoperative complication of thyroidectomy, particularly in endoscopic thyroid surgery (ETS). We hereby report a case of HS due to ETS with a brief literature review on this topic. Case presentation A 31-year-old female was admitted to our hospital with an unexpected physical examination finding of two thyroid nodules that were hypoechoic, had an irregular shape, and exhibited calcification. Subsequently, the results of a fine-needle aspiration (FNA) biopsy from the thyroid nodules and BRAFV600E mutation further confirmed the malignancy of these nodules. Thus, total thyroidectomy combined with central lymph node dissection (CLND) by ETS via the bilateral axillo-breast approach was performed on this patient. Histology confirmed the diagnosis of papillary thyroid microcarcinoma (PTMC) concurrent with Hashimoto’s thyroiditis (HT). However, this patient developed HS with ptosis in her left eye on postoperative day 3. All symptoms gradually resolved before the 3-month follow-up. Conclusion HS subsequent to ETS is a rare complication. Thus, standardized and appropriate operative procedures, as well as subtle manipulation, are essential in preventing and reducing the occurrence of HS. In addition, the early diagnosis and management of this rare complication are also important for a favorable outcome.

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Horner’s syndrome: an unusual complication of thyroidectomy: a case report

Cited by 15 publications

References 5 publications

Postoperative Horner’s syndrome following excision of incidental cervical ganglioneuroma during hemithyroidectomy and parathyroid gland exploration

Postoperative Horner’s syndrome following excision of incidental cervical ganglioneuroma during hemithyroidectomy and parathyroid gland exploration

Horner syndrome as a postoperative complication after minimally invasive video-assisted thyroidectomy

Case report and literature review: Horner syndrome subsequent to endoscopic thyroid surgery

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