Foma W, Pegbessou E, Amana B, Kpemissi E
Service d'ORL et chirurgie cervicofaciale, CHU Sylvanus Olympio, BP 57, Lomé, Togo.
Service d'ORL et chirurgie cervicofaciale, CHU Sylvanus Olympio, BP 57, Lomé, Togo.
Eur Ann Otorhinolaryngol Head Neck Dis. 2017 May;134(3):207-208. doi: 10.1016/j.anorl.2017.01.002. Epub 2017 Feb 16.
The authors report a case of left parapharyngeal ectopic goitre, in which resection was followed by postoperative Horner's syndrome, and describe the difficult management of this entity.
A 25-year-old woman presented with upper oesophageal dysphagia and a well-demarcated left parapharyngeal mass displacing the great vessels laterally and posteriorly. The mass was resected via an exploratory neck incision. Histological examination of the operative specimen revealed hyperplastic thyroid parenchyma. The postoperative work-up revealed a eutopic and euthyroid thyroid gland. The postoperative course was marked by Horner's syndrome that persisted at 1-year follow-up.
Parapharyngeal ectopic thyroid coexisting with a functional thyroid is extremely rare. Parapharyngeal masses are usually derived from the parotid gland and nerves. Surgery of the parapharyngeal space can cause injury to the sympathetic trunk, responsible for Horner's syndrome, as in our patient.
Ectopic thyroid should be considered as a possible diagnosis of a parapharyngeal mass. Although rare, Horner's syndrome is a dreaded complication of surgery of the parapharyngeal space.
作者报告一例左咽旁异位甲状腺肿病例，该病例在切除术后出现霍纳综合征，并描述了对此类病症的困难处理。
一名25岁女性因食管上段吞咽困难就诊，其左咽旁有一界限清楚的肿块，将大血管向外后方推移。通过颈部探查切口切除该肿块。手术标本的组织学检查显示甲状腺实质增生。术后检查发现甲状腺位置正常且甲状腺功能正常。术后病程以霍纳综合征为特征，在1年随访时该综合征仍持续存在。
与功能性甲状腺并存的咽旁异位甲状腺极为罕见。咽旁肿块通常源自腮腺和神经。如我们的患者一样，咽旁间隙手术可能会损伤交感干，从而导致霍纳综合征。
异位甲状腺应被视为咽旁肿块的一种可能诊断。尽管罕见，但霍纳综合征是咽旁间隙手术可怕的并发症。
