Horner syndrome-A rare complication after thyroidectomy for benign thyroid swelling

Area of Science:

• Endocrinology
• Neurosurgery

Background:

• Thyroidectomy is a common surgical procedure.
• Horner syndrome is a rare complication following thyroidectomy, often associated with malignant thyroid conditions.
• This report focuses on a case of Horner syndrome after surgery for benign goiter.

Observation:

• A 27-year-old female presented with ptosis, miosis, enophthalmos, and anhidrosis post-thyroidectomy for benign goiter.
• Diagnostic workup including ultrasound, CT scan, nerve conduction studies, and EMG were unremarkable.
• The patient received conservative management, including a short course of oral Prednisolone and thyroxine replacement.

Findings:

• Significant improvement in ptosis, miosis, and enophthalmos was observed after six months of conservative management.
• The patient's symptoms indicated a diagnosis of Horner syndrome, characterized by a specific set of neurological signs affecting the face and eye.
• No specific reversible cause like hematoma was identified, suggesting a possible iatrogenic injury to the sympathetic chain.

Implications:

• Horner syndrome post-thyroidectomy, though rare, can lead to significant cosmetic disfigurement.
• Surgeons must maintain awareness of this potential complication for prompt recognition and management.
• Early intervention for reversible causes and initiation of oral steroids may improve outcomes.