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Horner syndrome after thyroid-related surgery: a review

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Abstract

Background

Horner syndrome (HS) is caused by damage to the cervical sympathetic nerve. HS is a rare complication after thyroidectomy. The main manifestations of HS include miosis and ptosis of the eyelids, which seriously affect esthetics and quality of life. At present, there is a lack of research on HS after thyroidectomy, and its etiology is not completely clear. This review aimed to evaluate how to reduce the incidence of HS and promote the recovery from HS as well as to provide a reference for the protection of cervical sympathetic nerves during surgery.

Results

HS caused by thyroid surgery is not particularly common, but it is still worthy of our attention. After searching with “Horner Syndrome,” “Thyroid” as keywords, a total of 22 related cases were screened in PubMed. The results showed that open surgery, endoscopy, microwave ablation, and other surgical methods may have HS after operation. In addition, the statistics of 1213 thyroid surgeries in our hospital showed that the incidence of HS after endoscopic surgery (0.39%) was slightly higher than that after open surgery (0.29%). Further, this review analyzed potential causes of HS after thyroidectomy, so as to provide a theoretical basis for reducing its incidence.

Conclusion

Preventing HS during thyroidectomy is a difficult problem. The close and highly variable anatomical relationship between the thyroid and cervical sympathetic nerves increases the risk of sympathetic nerve damage during thyroidectomy. Surgery and the use of energy equipment are also closely related to the occurrence of HS.

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Funding

This work was supported by the Chongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau) (No. 2021MSXM314) and Medical Science and Technology Innovation Fund of Chongqing General Hospital (No. 2019ZDXM01 and Y2020ZDXM08).

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Author notes

  1. Hongdan Chen and Fan Zhang contributed equally to this work.

Authors and Affiliations

  1. Department of Breast and Thyroid Surgery, Chongqing General Hospital, Chongqing, 401147, China

    Mi Tang, Supeng Yin, Zeyu Yang, Yiceng Sun, Hongdan Chen & Fan Zhang

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  1. Mi Tang
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  2. Supeng Yin
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  3. Zeyu Yang
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  4. Yiceng Sun
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Contributions

Study conception: FZ, HDC, and MT; acquisition of data: MT and SPY; analysis and interpretation of data: MT, ZYY, and SYC; drafting of manuscript: MT and HDC; critical revision of manuscript: FZ.

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Correspondence to Hongdan Chen or Fan Zhang.

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Tang, M., Yin, S., Yang, Z. et al. Horner syndrome after thyroid-related surgery: a review. Langenbecks Arch Surg 407, 3201–3208 (2022). https://doi.org/10.1007/s00423-022-02636-z

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