Manoharan Sangeetha, Mustapha Mushawiahti, Abdullah Suhaimi Shahrun Nizam, Md Din Norshamsiah
Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS.
Breast and Endocrine Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS.
Cureus. 2023 Apr 24;15(4):e38046. doi: 10.7759/cureus.38046. eCollection 2023 Apr.
Post-thyroidectomy Horner's syndrome (HS) is a rare occurrence, and its probability increases when a modified radical neck dissection is performed. We present a case of a patient with papillary thyroid carcinoma who presented with Horner's syndrome one week after the right lateral dissection of the cervical lymph nodes. She underwent a complete thyroidectomy four months prior to this surgery. Both surgeries were uneventful intraoperatively. On examination, the right eye (RE) had partial ptosis with miosis and the absence of anhidrosis. A pharmacological test with phenylephrine 1% was used to localize the interruption of the oculosympathetic pathway with postganglionic third-order neuron involvement. She was treated conservatively, and her symptoms improved over time. Horner's syndrome is a rare and benign complication of post-thyroidectomy surgery with radical neck dissection surgery. Since it does not compromise visual acuity, the disease is constantly overlooked. However, in view of the facial disfigurement and the possibility of incomplete recovery, the patient needs to be forewarned regarding this complication.
甲状腺切除术后霍纳综合征（HS）较为罕见，在进行改良根治性颈清扫术时其发生概率会增加。我们报告一例甲状腺乳头状癌患者，在右侧颈部淋巴结清扫术后一周出现霍纳综合征。该患者在此次手术前四个月接受了全甲状腺切除术。两次手术术中均顺利。检查发现，右眼有部分上睑下垂、瞳孔缩小且无汗。使用1%去氧肾上腺素进行药理试验以定位眼交感神经通路中断且累及节后三级神经元。患者接受了保守治疗，症状随时间推移有所改善。霍纳综合征是甲状腺切除术后行根治性颈清扫术的一种罕见且良性的并发症。由于它不影响视力，该病常被忽视。然而，鉴于面部畸形以及不完全恢复的可能性，需要提前告知患者有关这种并发症的情况。
