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霍纳综合征:甲状腺切除术和选择性侧颈清扫术的一种罕见并发症。

Horner's Syndrome: An Uncommon Complication of Thyroidectomy and Selective Lateral Neck Dissection.

作者信息

Sapalidis K, Florou M, Tsopouridou K, Cheva A, Niki M, Pavlidis E, Koulouris C, Mantalovas S, Giannakidis D, Katsaounis A, Michalopoulos N, Alexandrou V, Zarogoulidis P, Amaniti A, Aidoni Z, Mogoanta S, Kosmidis C, Kesisoglou I

机构信息

3rdDepartment of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece.

Pathology Department, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

Curr Health Sci J. 2019 Jan-Mar;45(1):111-115. doi: 10.12865/CHSJ.45.01.15. Epub 2019 Mar 31.

Abstract

BACKGROUND

Horner's Syndrome is defined by myosis, enophthalmos, lack of sweating and eyelid ptosis, as well as vascular dilatation of one half of the face, caused by damage of the ipsilateral cervical sympathetic chain. It is known that Horner's syndrome is an unusual complication of thyroidectomy and selective lateral neck dissection. Its exact pathophysiology is not totally explained and its treatment remains conservative.

CASE PRESENTATION

A 27-year-old man developed one-sided partial eyelid ptosis, enophthalmos and myosis two hours after a total thyroid gland excision and a selective lateral neck dissection for papillary carcinoma. A clinical diagnosis of Horner's syndrome was formed. He was treated conservatively and presented with an incomplete recovery at a 2-month follow up.

CONCLUSIONS

The present case report underlines the adjacent anatomical correlation between the thyroid gland, the celluloadipose tissue and the cervical sympathetic trunk throughout thyroidectomy and selective lateral neck dissection. Every surgeon should be familiar with the potential complications in order to preoperatively counsel patients, as well as avoid them during the surgical procedure.

摘要

背景

霍纳综合征的定义为瞳孔缩小、眼球内陷、无汗和眼睑下垂,以及同侧颈交感神经链受损导致的半侧面部血管扩张。众所周知,霍纳综合征是甲状腺切除术和选择性侧颈清扫术的一种罕见并发症。其确切的病理生理学尚未完全阐明,治疗仍以保守为主。

病例报告

一名27岁男性在因乳头状癌行全甲状腺切除和选择性侧颈清扫术后两小时出现单侧部分眼睑下垂、眼球内陷和瞳孔缩小。形成了霍纳综合征的临床诊断。他接受了保守治疗,在2个月的随访中恢复不完全。

结论

本病例报告强调了在甲状腺切除术和选择性侧颈清扫术中甲状腺、蜂窝脂肪组织和颈交感干之间的相邻解剖关系。每位外科医生都应熟悉潜在的并发症,以便在术前为患者提供咨询,并在手术过程中避免这些并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6d5/6592676/9b42bdf4520f/CHSJ-45-01-111-fig1.jpg

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