Aslankurt Murat, Aslan Lokman, Colak Mustafa, Aksoy Adnan
Faculty of Medicine, Department of Ophthalmology, Sutcu Imam University, Kahramanmaraş, Turkey.
BMJ Case Rep. 2013 Jun 13;2013:bcr2013009907. doi: 10.1136/bcr-2013-009907.
We present a case of Horner's syndrome occurring as a complication of thyroidectomy. A 42-year-old female patient presented with eyelid drop which developed immediately after thyroidectomy for goitre. Ophthalmic examination revealed eyelid ptosis, miosis and anhidrosis. Preoperative ultrasonography showed multiple isohyperechogenic solid nodules in each lobe, consistent with multinodular goitre. Therefore, the patient underwent subtotal thyroidectomy. The ophthalmic findings did not improve at the end of 6 months follow-up. Similar cases have been reported related to neck tumours or their surgery, mediastinum-located goitre and retropharyngeal abscess surgeries, but not after benign nodular goitre surgery. Several possible mechanisms have been proposed to explain this phenomenon; anatomical variations making the patient susceptible to damage to the sympathetic chain seem to be most likely in our patient.
我们报告一例甲状腺切除术后并发霍纳综合征的病例。一名42岁女性患者,因甲状腺肿接受甲状腺切除术后立即出现眼睑下垂。眼科检查发现眼睑下垂、瞳孔缩小和无汗。术前超声检查显示每个叶有多个等回声和高回声实性结节,符合多结节性甲状腺肿。因此,该患者接受了甲状腺次全切除术。6个月随访结束时,眼科检查结果未改善。已有报道称类似病例与颈部肿瘤或其手术、纵隔甲状腺肿和咽后脓肿手术有关,但良性结节性甲状腺肿手术后未见报道。已经提出了几种可能的机制来解释这一现象;在我们的患者中,解剖变异使患者易受交感神经链损伤似乎是最有可能的原因。