Horner’s syndrome as a complication of thyroidectomy: Report of a case

Cozzaglio, Luca; Coladonato, Massimiliano; Doci, Roberto; Travaglini, P.; Vizzotto, Laura; Osio, Maurizio; Gennari, Leandro

doi:10.1007/s00595-007-3741-z

Cited by 33 publications

(38 citation statements)

References 15 publications

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“…Data from our present study suggest that tumor location might affect Roux stasis, as demonstrated in patients with tumors in the antrum who appeared to have a higher susceptibility to Roux stasis. Although we could not find direct evidence of a relationship between remnant stomach size and the tumor location, a relatively large remnant stomach has been shown to cause a high incidence of Roux stasis [21,22] and thus a large remnant stomach could affect Roux stasis in patients with tumors in the antrum.…”

Section: Discussionmentioning

confidence: 70%

The flow angle beneath the gastrojejunostomy predicts delayed gastric emptying in Roux-en-Y reconstruction after distal gastrectomy

et al. 2011

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Background Delayed gastric emptying without mechanical obstruction after Roux-en-Y reconstruction has been defined as Roux stasis syndrome. It occurs in 10-30% of patients after such reconstruction. So far, the cause of this stasis has not been completely identified. This study aimed to reduce Roux stasis using surgical techniques. Methods From November 2007 to October 2010, we performed 101 distal gastrectomies with Roux-en-Y reconstruction. All the gastrojejunostomies were performed with end-to-end anastomoses. Roux stasis was analyzed with respect to tumor location, extent of the dissection, tumor progression, operation time, antecolic/retrocolic reconstruction, and the shape of the gastrojejunostomy. The shape of the gastrojejunostomy was evaluated by contrast gastroradiography 4 days after the operation. Results Roux stasis syndrome was observed in 17 of the 101 patients. There was no relationship between the extent of the dissection, tumor progression, or operation time and the occurrence of Roux stasis. There was no difference in the incidence of Roux stasis between antecolic and retrocolic reconstructions. However, the group that displayed a straight anastomotic shape on contrast radiography demonstrated an apparently lower incidence of Roux stasis (p = 0.0003). In addition, Roux-en-Y reconstruction following gastric cancer was more frequently followed by Roux stasis in the antrum than in the midstomach (p = 0.0036). Cases of Roux stasis occurred 11.8 days after surgery on average and resolved within 2 weeks on average. Conclusions Our findings demonstrate the substantial benefits of a straight anastomosis of the gastrojejunostomy for the prevention of Roux stasis syndrome.

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Section: Discussionmentioning

confidence: 70%

The flow angle beneath the gastrojejunostomy predicts delayed gastric emptying in Roux-en-Y reconstruction after distal gastrectomy

et al. 2011

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“…Few cases have been reported since, and the majority of cases are associated with conventional thyroidectomy (8). To the best of our knowledge, there have been only 18 cases involving the development of HS as a complication of conventional thyroid surgery since 1993 (Table II) that have been reported in the literature (3,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Due to the development of surgical techniques over the previous two decades, cervical sympathetic damage has also been reported as a post-operative complication that develops subsequent to the completion of open minimally-invasive thyroidectomy and robotic-assisted endoscopic thyroidectomy (Table II).…”

Section: Discussionmentioning

confidence: 99%

“…Although neck surgery is a frequent iatrogenic cause of HS, thyroid surgery-associated HS is rare (3). A previous study reporting the occurrence of HS secondary to thyroidectomy mostly attributed the development of HS to conventional thyroidectomy (4).…”

Section: Introductionmentioning

confidence: 99%

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

Meng¹,

Tian²,

Lv³

et al. 2015

Oncology Letters

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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.

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“…Neoplasm of lung apex (Pancoast tumor), vascular injuries, syringohydromyelia, carotid dissection or fibromuscolar dysplasia, are the most common causes [1]. HS has only rarely been reported after thyroidectomy, with only 28 cases mostly published in surgical journals [2,3].…”

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confidence: 99%

“…The possible causes of HS following thyroidectomy include post-operative hematoma compressing the cervical sympathetic chain, ischemia-induced neural damage caused by lateral ligature on inferior thyroid artery trunk, stretching of the cervical sympathetic chain by the retractor, damage to the anastomosis between the cervical sympathetic chain and the recurrent laryngeal nerve during its identification [2]. Prognosis is usually poor with 70% of patients presenting permanent damage or incomplete recovery.…”

mentioning

confidence: 99%