Horner Syndrome Secondary to Thyroid Surgery.

Area of Science:

• Ophthalmology
• Endocrinology
• Neurosurgery

Background:

• Horner syndrome (HS) results from oculosympathetic pathway disruption, presenting with myosis, ptosis, and anhydrosis.
• HS is an infrequent but significant complication following thyroidectomy procedures.
• Thyroid nodules requiring surgical intervention necessitate careful consideration of potential iatrogenic complications.

Observation:

• A 15-year-old female presented with a large right thyroid lobe nodule.
• Following total thyroidectomy, the patient developed ipsilateral myosis and upper eyelid ptosis on postoperative day 2.
• The clinical presentation was an incomplete Horner syndrome, notably lacking vasomotor symptoms.

Findings:

• The patient was diagnosed with Horner syndrome post-thyroidectomy.
• Potential etiologies include ischemic nerve damage or sympathetic chain stretching during surgery.
• This case represents a rare instance of HS in a pediatric patient after thyroid surgery.

Implications:

• Clinicians must maintain a high index of suspicion for HS after thyroidectomy.
• Early recognition and diagnosis of HS are crucial for appropriate patient management.
• Understanding the mechanisms of HS can inform surgical techniques to minimize risk during thyroid procedures.