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甲状腺手术后继发霍纳综合征

Horner Syndrome Secondary to Thyroid Surgery.

作者信息

Demiral Meliha, Binay Ciğdem, Simsek Enver, Ilhan Hüseyin

机构信息

Department of Pediatric Endocrinology, School of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.

Department of Pediatric Surgery, School of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.

出版信息

Case Rep Endocrinol. 2017;2017:1689039. doi: 10.1155/2017/1689039. Epub 2017 Jan 4.

Abstract

Horner syndrome (HS), caused by an interruption in the oculosympathetic pathway, is characterised by myosis, ipsilateral blepharoptosis, enophthalmos, facial anhydrosis, and vascular dilation of the lateral part of the face. HS is a rare complication of thyroidectomy. A 15-year-old female patient presented with solitary solid and large nodule in the right thyroid lobe. Ultrasound-guided fine-needle aspiration was performed and the cytological examination results were undefined. The patient underwent a total thyroidectomy. On postoperative day 2, she developed right-sided myosis and upper eyelid ptosis. HS was diagnosed. Interestingly, the patient exhibited an incomplete clinical syndrome with the absence of vasomotor symptoms. We herein report a case of HS in a 15-year-old female patient after total thyroidectomy. The possible causes of HS were ischaemia-induced nerve damage and stretching of the cervical sympathetic chain by the retractor during thyroidectomy. Clinicians should be aware of the possibility of this rare but important surgical complication.

摘要

霍纳综合征(HS)由眼交感神经通路中断引起,其特征为瞳孔缩小、同侧上睑下垂、眼球内陷、面部无汗以及面部外侧血管扩张。HS是甲状腺切除术的一种罕见并发症。一名15岁女性患者右侧甲状腺叶出现孤立性实性大结节。进行了超声引导下细针穿刺,细胞学检查结果不明确。该患者接受了全甲状腺切除术。术后第2天,她出现右侧瞳孔缩小和上睑下垂。诊断为HS。有趣的是,该患者表现出不完全临床综合征,无血管运动症状。我们在此报告一例15岁女性患者全甲状腺切除术后发生HS的病例。HS的可能原因是缺血性神经损伤以及甲状腺切除术中牵开器对颈交感神经链的牵拉。临床医生应意识到这种罕见但重要的手术并发症的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f4b/5241455/1ec094f5faa7/CRIE2017-1689039.001.jpg

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