Iatrogenic Horner’s syndrome after thyroidectomy and neck dissection

Abstract Horner’s syndrome or oculosympathetic palsy is caused by disruption to the oculosympathetic pathway and presents with symptoms such as ptosis, enophthalmos, miosis, facial anhidrosis, and vascular dilatation of the lateral part of the face. However, it is seldom reported as a complication of neck surgeries like thyroidectomy and neck dissection. Here, we describe the case of a young female with papillary thyroid carcinoma developing Horner’s syndrome after total thyroidectomy and neck dissection. Intraoperatively, right Level IV cervical lymph nodes were found adherent to the right cervical sympathetic chain. Postoperatively, she developed Horner’s syndrome, which was treated with systemic corticosteroids and neurotrophic agents, leading to significant improvement in 6 weeks. Surgeons should be aware of this rare complication to prevent its occurrence.