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Giannaccare G, Gizzi C, Fresina M. Horner Syndrome Following Thyroid Surgery: The Clinical and Pharmacological Presentations. J Ophthalmic Vis Res. 2016;11(4):442-444doi: 10.4103/2008-322X.194146.
Giannaccare, G., Gizzi, C., & Fresina, M. (2016). Horner Syndrome Following Thyroid Surgery: The Clinical and Pharmacological Presentations. Journal of ophthalmic & vision research, 11(4), 442-444. https://doi.org/10.4103/2008-322X.194146
Giannaccare, Giuseppe, et al. "Horner Syndrome Following Thyroid Surgery: The Clinical and Pharmacological Presentations." Journal of ophthalmic & vision research vol. 11,4 (2016): 442-444. doi: https://doi.org/10.4103/2008-322X.194146
Giannaccare G, Gizzi C, Fresina M. Horner Syndrome Following Thyroid Surgery: The Clinical and Pharmacological Presentations. J Ophthalmic Vis Res. 2016 Oct-Dec;11(4):442-444. doi: 10.4103/2008-322X.194146. PMID: 27994816; PMCID: PMC5139559.
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J Ophthalmic Vis Res. 2016 Oct-Dec;11(4):442-444. doi: 10.4103/2008-322X.194146.

Horner Syndrome Following Thyroid Surgery: The Clinical and Pharmacological Presentations.

Journal of ophthalmic & vision research

Giuseppe Giannaccare, Corrado Gizzi, Michela Fresina

Affiliations

  1. Department of Specialist, Diagnostics and Experimental Medicine, Opthalmology Service, S.Orsola-Malpighi Teaching Hospital, University of Bologna, Italy.

PMID: 27994816 PMCID: PMC5139559 DOI: 10.4103/2008-322X.194146

Abstract

PURPOSE: To report the clinical and pharmacological findings of a patient with iatrogenic Horner syndrome (HS) which occurred after thyroid surgery.

CASE REPORT: A 29-year-old man was referred to our emergency ward due to anisocoria and unilateral eyelid ptosis reported by the patient immediately after a recent thyroidectomy for a papillary carcinoma. Ophthalmologic examination revealed 3 mm ptosis of the right eyelid. In dim illumination, the right and left pupil size was measured 3 and 6 mm, respectively. In bright illumination, the amount of anisocoria decreased; the near pupillary reaction was intact. Brain and neck magnetic resonance imaging and chest radiography were normal. Pharmacological tests with 10% cocaine, 1% hydroxyamphetamine and 1% phenylephrine localized the interruption of the oculosympathetic pathway with postganglionic third-order neuron involvement. After 6 months of follow-up, no sign of recovery was recorded.

CONCLUSION: Despite HS could appear to be a rare complication of thyroid surgery, it is of importance for the neck surgeons to be aware that oculosympathetic pathway (OSP) is a potentially vulnerable structure with close anatomical relationship with the thyroid gland, and for the ophthalmologists that HS may occur secondary to neck surgery and taking an accurate history is mandatory.

Keywords: Horner syndrome; Miosis; Ptosis; Thyroid Surgery

Conflict of interest statement

There are no conflicts of interest.

References

  1. Acta Otorrinolaringol Esp. 2012 Jul-Aug;63(4):299-302 - PubMed
  2. Surg Today. 2008;38(12):1114-6 - PubMed
  3. ANZ J Surg. 2004 Jun;74(6):442-5 - PubMed
  4. Surg Laparosc Endosc Percutan Tech. 2011 Aug;21(4):223-9 - PubMed
  5. J Otolaryngol. 1993 Dec;22(6):454-6 - PubMed
  6. Neurol Sci. 2011 Jun;32(3):531 - PubMed
  7. Curr Opin Ophthalmol. 2003 Dec;14(6):357-63 - PubMed
  8. Neuroimaging Clin N Am. 2008 May;18(2):369-85, xi - PubMed
  9. Proc R Soc Med. 1961 Oct;54:871-3 - PubMed
  10. Br J Surg. 1965 Sep;52:673-5 - PubMed
  11. Surg Gynecol Obstet. 1963 Nov;117:535-9 - PubMed

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