Anesth Pain Med.  2016 Jul;11(3):313-317. 10.17085/apm.2016.11.3.313.

Painful Horner syndrome after thyroidectomy: A case report

  • 1Department of Anesthesiology and Pain Medicine, Kwangju Christian Hospital, Gwangju, Korea.


Horner syndrome is characterized by miosis, partial blepharoptosis and anhidrosis on the affected side of the face. This syndrome develops when the oculosympathetic nerve pathways to the eye and face are interrupted by various causes such as tumor in the brain, intrathoracic region or neck, surgery, drugs, trauma, carotid artery dissection, and others. It is referred to as painful Horner syndrome when Horner syndrome is accompanied by hemifacial pain. Pain is probably related to trigeminal nerve injury. Horner syndrome is a rare complication of thyroidectomy. Here, we report the case of a patient who experienced ipsilateral painful Horner syndrome after total thyroidectomy and unilateral neck dissection for thyroid cancer.


Horner syndrome; Pain; Thyroidectomy

MeSH Terms

Carotid Artery Injuries
Horner Syndrome*
Neck Dissection
Thyroid Neoplasms
Trigeminal Nerve Injuries


  • Fig. 1 Preoperative non-enhanced computed tomographic image of neck. Two nodules with rim calcification are noticed in left thyroid (arrows).

  • Fig. 2 Preoperative ultrasonography of left lateral neck. Hypoechoic abnormal lymph nodes (arrows) are beside the left internal jugular vein.

  • Fig. 3 Oculosympathetic nerve pathways. Trigeminal fibers surrounding the internal carotid artery can develop during lymph node dissection and probably induce painful Horner syndrome. SCG: superior cervical ganglion, MCG: middle cervical ganglion, ICG: inferior cervical ganglion, or stellate ganglion.


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