Horner's syndrome subsequent to minimally invasive video-assisted thyroidectomy in two patients

Meng,Kexin; Tian,Wei; Lv,Zhenye; Song,Xiangyang

doi:10.3892/ol.2015.3159

Horner's syndrome subsequent to minimally invasive video-assisted thyroidectomy in two patients

Authors:
- Kexin Meng
- Wei Tian
- Zhenye Lv
- Xiangyang Song
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Affiliations: Department of Thyroid Breast Surgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China, Department of Surgical Oncology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310009, P.R. China
Published online on: April 28, 2015 https://doi.org/10.3892/ol.2015.3159
Pages: 459-462

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Abstract

Horner's syndrome (HS), characterized by a combination of ptosis and miosis, is an uncommon complication of thyroid surgery, particularly in minimally invasive thyroid surgery. Two cases of HS were observed secondary to minimally invasive video‑assisted thyroidectomy in the Department of Thyroid Breast Surgery of Zhejiang Provincial People's Hospital between August 2012 and July 2014. The two patients developed miosis and ptosis following total thyroidectomy; all symptoms had resolved at 1 and 11 months subsequent to surgery, respectively. HS has currently been reported secondary to numerous types of minimally invasive thyroid procedures. The literature was reviewed to identify cases of this iatrogenic complication secondary to each type of thyroidectomy and the possible injury mechanisms underlying the syndrome were summarized in the present study. In addition, factors that were associated with minimally invasive thyroidectomy, such as the limited endoscopic vision during the procedure, the retraction effect and the occurrence of thermal damage from the use of the harmonic scalpel, were emphasized. The present study concluded that close attention is required during minimally invasive thyroid surgery in order to avoid HS as a complication of the procedure.

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1	Horner F: Über eine Form von Ptosis. Klin Monatsbl Augenheilkd. 7:193–198. 1869.
2	Reede DL, Garcon E, Smoker WR and Kardon R: Horner's syndrome: Clinical and radiographic evaluation. Neuroimaging Clin N Am. 18:369–385. 2008. View Article : Google Scholar : PubMed/NCBI
3	Cozzaglio L, Coladonato M, Doci R, Travaglini P, Vizzotto L, Osio M and Gennari L: Horner's syndrome as a complication of thyroidectomy: Report of a case. Surg Today. 38:1114–1116. 2008. View Article : Google Scholar : PubMed/NCBI
4	Leuchter I, Becker M, Mickel R and Dulguerov P: Horner's syndrome and thyroid neoplasms. ORL J Otorhinolaryngol Relat Spec. 64:49–52. 2002. View Article : Google Scholar : PubMed/NCBI
5	Miccoli P, Berti P, Conte M, Bendinelli C and Marcocci C: Minimally invasive surgery for thyroid small nodules: Preliminary report. J Endocrinol Invest. 22:849–851. 1999. View Article : Google Scholar : PubMed/NCBI
6	Miccoli P, Berti P, Raffaelli M, Materazzi G, Baldacci S and Rossi G: Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: A prospective randomized study. Surgery. 130:1039–1043. 2001. View Article : Google Scholar : PubMed/NCBI
7	Kaelin W: Über Störungen von seiten des Halssympathicus bei einfacher Struma und im Anschluß an deren operative Behandlung. Dtsch Z Chir. 134:395–423. 1915. View Article : Google Scholar
8	Smith I and Murley RS: Damage to the cervical sympathetic system during operations on the thyroid gland. Br J Surg. 52:673–675. 1965. View Article : Google Scholar : PubMed/NCBI
9	Solomon P, Irish J and Gullane P: Horner's syndrome following a thyroidectomy. J Otolaryngol. 22:454–456. 1993.PubMed/NCBI
10	Harding JL, Sywak MS, Sidhu S and Delbridge LW: Horner's syndrome in association with thyroid and parathyroid disease. ANZ J Surg. 74:442–445. 2004. View Article : Google Scholar : PubMed/NCBI
11	Kang SW, Lee SC, Lee SH, et al: Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: The operative outcomes of 338 consecutive patients. Surgery. 146:1048–1055. 2009. View Article : Google Scholar : PubMed/NCBI
12	Lee J, Yun JH, Nam KH, Choi UJ, Chung WY and Soh EY: Perioperative clinical outcomes after robotic thyroidectomy for thyroid carcinoma: A multicenter study. Surg Endosc. 25:906–912. 2011. View Article : Google Scholar : PubMed/NCBI
13	Rosato L, Avenia N, Bernante P, De Palma M, Gulino G, Nasi PG, Pelizzo MR and Pezzullo L: Complications of thyroid surgery: Analysis of a multicentric study on 14,934 patients operated on in Italy over 5-years. World J Surg. 28:271–276. 2004. View Article : Google Scholar : PubMed/NCBI
14	Italiano D, Cammaroto S, Cedro C, Bramanti P and Ferlazzo E: Horner syndrome following thyroidectomy. Neurol Sci. 32:5312011. View Article : Google Scholar : PubMed/NCBI
15	de Silva WD, de Soysa MS and Perera BL: Iatrogenic Horner's syndrome: A rare complication of thyroid surgery. Ceylon Med J. 55:1362010. View Article : Google Scholar : PubMed/NCBI
16	Vilallonga R, Fort JM, Mazarro A, Gonzalez O, Caubet E, Romero G and Armengol M: Postthyroidectomy Horner's Syndrome. Case Rep Med. 2012:3169842012.PubMed/NCBI
17	Aslankurt M, Aslan L, Colak M and Aksoy A: Horner's syndrome following a subtotal thyroidectomy for a benign nodular goitre. BMJ Case Rep. pii:bcr20130099072013.
18	Tan C, Sidhu S, Sywak M and Delbridge L: Management of hyperfunctioning single thyroid nodules in the era of minimally invasive thyroid surgery. ANZ J Surg. 79:386–389. 2009. View Article : Google Scholar : PubMed/NCBI
19	Lee YS, Nam KH, Chung WY, Chang HS and Park CS: Postoperative complications of thyroid cancer in a single center experience. J Korean Med Sci. 25:541–545. 2010. View Article : Google Scholar : PubMed/NCBI
20	González-Aguado R, Morales-Angulo C, Obeso-Agüera S, Longarela-Herrero Y, García-Zornoza R and Acle Cervera L: Horner's syndrome after neck surgery. Acta Otorrinolaringol Esp. 63:299–302. 2012. View Article : Google Scholar : PubMed/NCBI
21	Reeve TS, Coupland GA, Johnson DC and Buddee FW: The recurrent and external laryngeal nerves in thyroidectomy. Med J Aust. 1:380–382. 1969.PubMed/NCBI
22	de Quervain F: Weiteres zur Technik der Kropfoperation. Dtsch Z Chir. 134:475–520. 1915. View Article : Google Scholar
23	Carlander J, Johansson K, Lindström S, Velin AK, Jiang CH and Nordborg C: Comparison of experimental nerve injury caused by ultrasonically activated scalpel and electrosurgery. Br J Surg. 92:772–777. 2005. View Article : Google Scholar : PubMed/NCBI
24	Hallgrimsson P, Lovén L, Westerdahl J and Bergenfelz A: Use of the harmonic scalpel versus conventional haemostatic techniques in patients with Grave disease undergoing total thyroidectomy: A prospective randomised controlled trial. Langenbecks Arch Surg. 393:675–680. 2008. View Article : Google Scholar : PubMed/NCBI