Remedy Publications LLC., | http://surgeryresearchjournal.com World Journal of Surgery and Surgical Research 2021 | Volume 4 | Article 1279 1 Eye Sign and Syndrome after Thyroidectomy OPEN ACCESS *Correspondence: Mayilvaganan Sabaretnam, Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareily Road, Lucknow - 226 014, India, Tel: +91 (0522) 2668004- 8 (Ext 3200), 2668777; Fax: +91 (0522) 2668777; E-mail: drretnam@gmail.com Received Date: 23 Dec 2020 Accepted Date: 25 Jan 2021 Published Date: 03 Feb 2021 Citation: Sabaretnam M, Idrees S, VNSSVAMS Mahalakshmi D, Bhargav PRK, Chekavar A, Manogaran R. Eye Sign and Syndrome after Thyroidectomy. World J Surg Surgical Res. 2021; 4: 1279. Copyright © 2021 Mayilvaganan Sabaretnam. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Case Report Published: 03 Feb, 2021 Abst ract Tyroidectomy is not associated in majority with complications and rarely associated with complications like Horner syndrome which has signifcant impact on quality of life. We report a case of papillary carcinoma thyroid that had completion thyroidectomy with central compartment lymph node dissection and developed ptosis, miosis, enophthalmos on post-operative day 1 without anhidrosis. Possible cause in this case could be trauma from retraction or injury to communicating branch from RLN as it was a re-operative case. So with complete knowledge of surgical anatomy and careful dissection, this complication can be avoided. Mayilvaganan Sabaretnam 1 *, Sarrah Idrees 1 , VNSSVAMS Mahalakshmi D 1 , PRK Bhargav 1 , Aromal Chekavar 1 and Ravisankar Manogaran 2 1 Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, India 2 Department of Neuro-otology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, India Introduction Tyroidectomy is commonly performed procedure across the world. It is associated with certain well established morbidities like RLN palsy and hypoparathyroidism, but there are certain preventable complications which are rare but have signifcant impact on quality of life, Horner syndrome is one of these. It is characterized by miosis, eyelid ptosis, enophthalmos, and lack of sweating, with vascular dilatation of the lateral part of the face, caused by damage of the cervical sympathetic chain [1]. Mid ganglion is injury is the commonest site of damage as it is in close proximity with inferior thyroid artery. Capsular dissection and careful dissection can avert this complication. Case Presentation We report Horner syndrome in a 22 years young lady who underwent completion thyroidectomy along with central compartment lymph node dissection for papillary carcinoma thyroid. She underwent right hemithyroidectomy for right thyroid nodule with pre-operative benign cytology. Patient has an uneventful recovery and fnal histology showed a 1.5 cm focus of papillary carcinoma thyroid in isthmic region. In view of this, patient was planned for completion surgery afer six weeks. In completion thyroidectomy, there were dense adhesions in the central compartment and multiple black cyst nodes were noticed on the index side. Bilateral recurrent laryngeal nerves and superior parathyroids were identifed and preserved and both inferior parathyroids were auto-transplanted in to sternocleidomastoid muscle. Patient developed right eye ptosis, miosis and enophthalmos on 1 st post-operative day without any evidence anhidrosis. Neurological and Ophthalmological examination also ruled out any other cause of Horner syndrome. Patient did not have hoarseness of voice and symptomatic hypocalcemia in post-operative period. Discussion Horner syndrome is rare complication afer thyroidectomy with only few cases reported so far in literature. Horner syndrome occurs due to disruption of sympathetic innervations to ocular muscles. Te occulosympathetic system can be regarded as a three neuron pathway. Te frst order neurons of the sympathetic pathway originate in the central nervous system arising in the posterolateral hypothalamus to synapse in the thoracic segment of the spinal cord. Te second order neurons from the spinal cord enter the sympathetic chain ascending through the inferior and middle cervical ganglion, synapse in the superior cervical ganglion at the level of the carotid bifurcation and the third-order neurons emerge from the superior cervical ganglion and innervate Mueller's muscle of the upper and lower lids and the lacrimal gland as well as the dilator muscle of the iris [1]. Horner syndrome can occur due to disruption of innervations at any level. Tyroid pathology both benign and malignant is the most common cause of a neck mass associated with Horner syndrome accounts for nearly 1.3% out of all case with sympathetic chain compromise is usually caused by mass pressure efects rather than malignant infltration [2]. In post-operative period the possible