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Case Reports
. 2023 Sep 28:10:1267701.
doi: 10.3389/fsurg.2023.1267701. eCollection 2023.

Diagnosis and treatment of HS after endoscopic thyroid surgery: case report and brief literature review

Yuqing Deng  1 , Guoqian Ding  1
Affiliations
Case Reports

Diagnosis and treatment of HS after endoscopic thyroid surgery: case report and brief literature review

Yuqing Deng et al. Front Surg. .

Abstract

Background: Horner's syndrome (HS) is a rare condition due to damage to the 3-neuron sympathetic pathway anywhere between the posterior-lateral nuclei of the hypothalamus and the oculosympathetic fiber, particularly as a post-thyroidectomy symptom. In this case report, we present a case of HS following endoscopic thyroid surgery (ETS) and briefly review the literature.

Case report: During a routine physical examination, a 29-year-old female patient was incidentally found to have multiple nodules in the right thyroid. She was subsequently admitted to the Department of General Surgery for further examinations and treatment. A fine-needle aspiration biopsy confirmed malignancy in these nodules. As a result, the patient underwent radical resection of the right thyroid and ipsilateral central lymph node dissection using endoscopy. Pathological diagnosis revealed papillary thyroid carcinoma. Unexpectedly, on the third day after the operation, the patient was diagnosed with Horner's syndrome based on the presence of miosis and ptosis. After 1 week of follow-up, the symptoms related to HS significantly improved.

Conclusion: Horner's syndrome is an uncommon complication of thyroidectomy in patients undergoing ETS. Therefore, it is crucial to perform careful operations and minimize iatrogenic surgical damage to reduce the incidence of HS. This case serves as a reminder that making rational judgments and implementing appropriate measures are essential for achieving a favorable prognosis and preserving facial esthetics.

Keywords: Horner’s syndrome; case report; diagnosis; postoperative complications; thyroid neoplasms.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Ultrasound image expresses a thyroid nodule (0.70 cm × 0.70 cm × 0.90 cm) located at the inferior thyroid on the right side (shown by a black arrow).
Figure 2
Figure 2
Microscopic image of this patient shows papillary thyroid carcinoma (H&E staining, ×20 magnification).
Figure 3
Figure 3
A patient suffered from right-side ptosis after acceptancy of ETS (shown by a black arrow).
See this image and copyright information in PMC

References

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