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We report a case of Horner’s syndrome (HS) occurring as a complication after total thyroidectomy. Horner’s syndrome is characterized
by myosis, 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. We found only 28 other reports of HS developing after thyroidectomy, and only
seven of these patients recovered completely. Of the 495 thyroidectomies performed at our hospital between 1997 and 2007,

Conclusions  Additional incisions can be made if thyroidectomy cannot be done transcervically and if the goiter extends to the level of
the aortic arch. If the thyroid gland extends below the aortic arch and the lateral diameter of the goiter is greater than
10 cm, a partial sternotomy may be required. Total sternotomy is needed when an RSG extends caudally to the azygos vein, if
it is located in the retrotracheal or retroesophageal space, or if it is recurrent or ectopic. Coexisting lung disorders and
goiters extending to the left atrium also require thoracotomy.

Authors: Karaoglu A, Aydin S, Dagli AF, Cummings DE, Ozercan IH, Canatan H, Ozkan Y