Concurrent Horner's and Harlequin syndromes

Area of Science:

• Neurology
• Surgical Anatomy

Background:

• Horner's syndrome and Harlequin syndrome arise from sympathetic nervous system dysfunction affecting the face.
• Etiologies include nerve compression, idiopathic factors, and iatrogenic causes, with rare occurrences post-thyroid or cervical surgery.

Observation:

• A patient developed both Horner's syndrome and Harlequin syndrome following surgical excision of papillary carcinoma and neck dissection.
• This dual presentation is exceptionally rare, particularly in adult patients.

Findings:

• The study details the anatomical pathways of sympathetic innervation to the face.
• It illustrates how surgical manipulation during neck dissection can disrupt these pathways, leading to both syndromes.

Implications:

• This case underscores the importance of understanding cervical and thoracic surgical anatomy for preventing iatrogenic nerve injuries.
• Awareness of this potential complication is crucial for multiple surgical specialties operating in the head and neck region.