- 期刊
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- Ahead-of-Print
Horner syndrome subsequent to thyroidectomy-Two Cases Report and Literature Review
摘要
Background: Horner syndrome is a rare but disturbing complication of thyroidectomy which results from injury to the cervical sympathetic chain. It presents classically with symptoms of ptosis, miosis, and facial anhidrosis. We present a report of two such cases and conduct a comprehensive literature review of the pathophysiology, management, and prognosis of Horner syndrome. Case presentation: Two middle-aged female patients were diagnosed with papillary thyroid carcinoma with cervical lymph node metastasis. One underwent endoscopic thyroid surgery with central lymph node dissection and the other received conventional thyroidectomy with lateral lymph node dissection. Both patients developed classic symptoms of Horner syndrome included ptosis and miosis after surgery, then soon being diagnosed at our endocrinology outpatient clinic. Their vision was not impaired but such appearance impacted patient's mood strikingly. Their symptoms ameliorated gradually during subsequent follow-up. Conclusions: Horner syndrome is an infrequent complication of thyroidectomy. It is more often associated with lateral neck lymph node dissection and is usually self-limited, but may be cosmetically distressful to the patient. Surveillance of the classic symptoms allows early diagnosis. Testing with cocaine and apraclonidine eye drops can help to confirm the diagnosis. Sound perioperative management including thorough preoperative evaluation and selection of the most appropriate surgical approach minimizes the risk of Horner syndrome.