Arishi Abdulaziz A, Abualhana Farouk, Sferra Joseph
General Surgery, Faculty of Medicine, Jazan University, Jazan, SAU.
General Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, USA.
Cureus. 2023 Sep 23;15(9):e45825. doi: 10.7759/cureus.45825. eCollection 2023 Sep.
Horner's syndrome (HS) is a rare complication of thyroidectomy caused by damage to the oculosympathetic nerves. This article reports the case of a 29-year-old woman referred to the clinic with a newly diagnosed papillary thyroid carcinoma (PTC). Ultrasound studies were concerning for multiple thyroid nodules and an enlarged lymph node, confirmed by a computed tomography (CT) scan. Cytology results of fine needle aspiration (FNA) diagnostic for PTC showed tumors in the thyroid tissue and lymph node. The patient underwent a thyroidectomy and woke up with right-sided ptosis and miosis. Clinical follow-up revealed subjective ipsilateral anhidrosis. She also developed a low parathyroid hormone level and dysphonia, albeit they resolved after months. The patient still exhibits HS eight months after surgery. This paper reviews the literature and attempts to establish the most probable causal factor while providing implications for surgical teams to minimize HS occurrence in future thyroid surgeries.
霍纳综合征（HS）是甲状腺切除术后一种罕见的并发症，由眼交感神经受损引起。本文报告了一名29岁女性的病例，该患者因新诊断出的甲状腺乳头状癌（PTC）前来诊所就诊。超声检查发现多个甲状腺结节和一个肿大的淋巴结，计算机断层扫描（CT）证实了这一情况。细针穿刺抽吸（FNA）诊断为PTC的细胞学结果显示甲状腺组织和淋巴结中有肿瘤。患者接受了甲状腺切除术，术后醒来出现右侧上睑下垂和瞳孔缩小。临床随访发现同侧有主观无汗。她还出现了甲状旁腺激素水平低和声音嘶哑的症状，不过数月后这些症状都消失了。术后八个月，该患者仍表现出霍纳综合征。本文回顾了相关文献，试图确定最可能的病因，同时为手术团队提供建议，以尽量减少未来甲状腺手术中霍纳综合征的发生。
