J Korean Ophthalmol Soc.  2021 Jan;62(1):132-136. 10.3341/jkos.2021.62.1.132.

Iatrogenic Horner’s Syndrome Developing after Robot-assisted Transaxillary Total Thyroidectomy

• Lee SH
• Kang SM

• KMID: 2511536
• DOI: http://doi.org/10.3341/jkos.2021.62.1.132

Abstract

Purpose
We report a case of iatrogenic Horner’s syndrome developing after robot-assisted transaxillary total thyroidectomy.
Case summary
A 31-year-old female with right-eye ptosis was referred to our clinic. Three weeks prior, she had undergone robot-assisted total thyroidectomy via the right transaxillary approach to treat right-side thyroid cancer. On ocular examination, the palpebral fissure widths were 5.0 mm in the right lid and 8.0 mm in the left lid, the marginal reflex distances 1, 1.0 mm in the right lid and 4.0 mm in the left lid, and the levator muscle function of both eyes normal. In a dark room, the pupil diameter was 2.5 mm in the right eye and 4.0 mm in the left eye. She did not complain of facial anhidrosis. Thirty minutes after instillation of 0.5% (w/v) apraclonidine into the right eye, the right palpebral fissure width increased from 5.0 to 8.0 mm, and the pupil size from 2.5 to 4.0 mm in the dark.
Conclusions
Horner’s syndrome can develop after robot-assisted transaxillary total thyroidectomy; patients should be counselled in this regard.

Keyword

Horner’s syndrome, Iatrogenic, Robot-assisted surgery, Thyroidectomy