Naphazoline eye drops for the treatment of Horner syndrome following radical thyroid cancer surgery: A case report

Horner syndrome is a rare complication following thyroid surgery, typically presenting with ptosis, miosis, and ocular congestion. We report the case of a 30-year-old female diagnosed with papillary thyroid carcinoma who underwent left thyroid lobectomy, isthmectomy, and comprehensive left cervical...

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Main Authors: Zhuang Li, Yong Liu, Hang Yin, Jiatong Chen, Feng Zhu
Format: Article
Language:English
Published: SAGE Publishing 2025-08-01
Series:Journal of International Medical Research
Online Access:https://doi.org/10.1177/03000605251359467
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author Zhuang Li
Yong Liu
Hang Yin
Jiatong Chen
Feng Zhu
author_facet Zhuang Li
Yong Liu
Hang Yin
Jiatong Chen
Feng Zhu
author_sort Zhuang Li
collection DOAJ
description Horner syndrome is a rare complication following thyroid surgery, typically presenting with ptosis, miosis, and ocular congestion. We report the case of a 30-year-old female diagnosed with papillary thyroid carcinoma who underwent left thyroid lobectomy, isthmectomy, and comprehensive left cervical lymph node dissection. On the first postoperative day, the patient developed left-sided ptosis, a constricted pupil, blurred vision, and conjunctival congestion, leading to a clinical diagnosis of Horner syndrome. Initial treatment with oral neurotrophic agents provided limited improvement, with persistent ocular symptoms. Four months postoperatively, the introduction of topical naphazoline eye drops resulted in marked improvement. Ptosis diminished, the palpebral fissure returned to normal, pupil sizes equalized, and conjunctival congestion resolved, with effects lasting approximately 2 h after each application. This case report summarizes the mechanisms of injury leading to Horner syndrome after thyroid surgery, highlighting the importance of understanding the anatomical relationship between the thyroid gland and the cervical sympathetic nerve trunk during thyroidectomy to minimize the risk of Horner syndrome. This case highlights the potential role of topical α 1 -adrenergic agonists in managing postoperative Horner syndrome and underscores the need for intraoperative nerve protection strategies.
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spelling doaj-art-01b1de39f99f4846a929bccfcac1e45f2025-08-20T18:03:57ZengSAGE PublishingJournal of International Medical Research1473-23002025-08-015310.1177/03000605251359467Naphazoline eye drops for the treatment of Horner syndrome following radical thyroid cancer surgery: A case reportZhuang LiYong LiuHang YinJiatong ChenFeng ZhuHorner syndrome is a rare complication following thyroid surgery, typically presenting with ptosis, miosis, and ocular congestion. We report the case of a 30-year-old female diagnosed with papillary thyroid carcinoma who underwent left thyroid lobectomy, isthmectomy, and comprehensive left cervical lymph node dissection. On the first postoperative day, the patient developed left-sided ptosis, a constricted pupil, blurred vision, and conjunctival congestion, leading to a clinical diagnosis of Horner syndrome. Initial treatment with oral neurotrophic agents provided limited improvement, with persistent ocular symptoms. Four months postoperatively, the introduction of topical naphazoline eye drops resulted in marked improvement. Ptosis diminished, the palpebral fissure returned to normal, pupil sizes equalized, and conjunctival congestion resolved, with effects lasting approximately 2 h after each application. This case report summarizes the mechanisms of injury leading to Horner syndrome after thyroid surgery, highlighting the importance of understanding the anatomical relationship between the thyroid gland and the cervical sympathetic nerve trunk during thyroidectomy to minimize the risk of Horner syndrome. This case highlights the potential role of topical α 1 -adrenergic agonists in managing postoperative Horner syndrome and underscores the need for intraoperative nerve protection strategies.https://doi.org/10.1177/03000605251359467
spellingShingle Zhuang Li
Yong Liu
Hang Yin
Jiatong Chen
Feng Zhu
Naphazoline eye drops for the treatment of Horner syndrome following radical thyroid cancer surgery: A case report
Journal of International Medical Research
title Naphazoline eye drops for the treatment of Horner syndrome following radical thyroid cancer surgery: A case report
title_full Naphazoline eye drops for the treatment of Horner syndrome following radical thyroid cancer surgery: A case report
title_fullStr Naphazoline eye drops for the treatment of Horner syndrome following radical thyroid cancer surgery: A case report
title_full_unstemmed Naphazoline eye drops for the treatment of Horner syndrome following radical thyroid cancer surgery: A case report
title_short Naphazoline eye drops for the treatment of Horner syndrome following radical thyroid cancer surgery: A case report
title_sort naphazoline eye drops for the treatment of horner syndrome following radical thyroid cancer surgery a case report
url https://doi.org/10.1177/03000605251359467
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