BMJ Case Reports 2013; doi:10.1136/bcr-2013-009907

Horner's syndrome following a subtotal thyroidectomy for a benign nodular goitre

  1. Adnan Aksoy1
  1. 1Faculty of Medicine, Department of Ophthalmology, Sutcu Imam University, Kahramanmaraş, Turkey
  2. 2Department of General Surgery, Pazarcık State Hospital, Kahramanmaraş, Turkey
  1. Correspondence to Dr Murat Aslankurt, maslankurt80{at}


We present a case of Horner's syndrome occurring as a complication of thyroidectomy. A 42-year-old female patient presented with eyelid drop which developed immediately after thyroidectomy for goitre. Ophthalmic examination revealed eyelid ptosis, miosis and anhidrosis. Preoperative ultrasonography showed multiple isohyperechogenic solid nodules in each lobe, consistent with multinodular goitre. Therefore, the patient underwent subtotal thyroidectomy. The ophthalmic findings did not improve at the end of 6 months follow-up. Similar cases have been reported related to neck tumours or their surgery, mediastinum-located goitre and retropharyngeal abscess surgeries, but not after benign nodular goitre surgery. Several possible mechanisms have been proposed to explain this phenomenon; anatomical variations making the patient susceptible to damage to the sympathetic chain seem to be most likely in our patient.

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