Horner's Syndrome as a Complication of Tonsillectomy: Comprehensive Literature Review.

Ahmad Alkheder, Hossam Alhraki, Vivian Alahmad, Zeina Alsodi, Salah Abdalkader, Adham Bader Aldeen Mohsen
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Abstract

Horner's syndrome, though very rare, is a recognized complication following tonsillectomy, as presented in this case report of a 4.5-year-old girl. She developed Horner's syndrome after a tonsillectomy, which was performed using cold steel technique and bipolar diathermy for hemostasis. The patient exhibited symptoms such as ptosis, miosis, and anhidrosis on the left side, detected following a secondary post-tonsillectomy hemorrhage that required surgical intervention. No improvement in Horner's syndrome was noted after 3 months. Our review of the literature revealed 15 documented cases of Horner's syndrome as a complication of tonsillectomy, with an increase in recent years possibly due to the advancements in surgical techniques and heightened awareness of the condition. Interestingly, Horner's syndrome occurred with a wide range of surgical methods, indicating that the etiology is likely multifactorial, involving factors such as surgical technique, anatomical variations, and the extent of cauterization. This report emphasizes the need for caution in the application of modern hemostatic techniques, advocating for a balanced approach that considers traditional methods like ligation and suturing, which may reduce the risk of such complications. Continuous reporting and further research are crucial to better understanding the mechanisms behind Horner's syndrome following tonsillectomy and improving patient outcomes.

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作为扁桃体切除术并发症的霍纳综合征:文献综述。
霍纳氏综合征虽然非常罕见,但却是扁桃体切除术后公认的并发症,本病例报告中的患者是一名 4.5 岁的女孩。她在使用冷钢技术和双极透热止血法进行扁桃体切除术后出现了霍纳综合征。患者表现出眼睑下垂、瞳孔缩小和左侧无汗等症状,扁桃体切除术后继发出血,需要手术治疗。3 个月后,霍纳氏综合征未见好转。通过查阅文献,我们发现有 15 例霍纳氏综合征作为扁桃体切除术并发症的病例记录在案,近年来病例增多的原因可能是手术技术的进步和人们对该病症认识的提高。有趣的是,Horner's 综合征的发生与多种手术方法有关,这表明病因可能是多因素的,涉及手术技术、解剖变异和烧灼程度等因素。本报告强调在应用现代止血技术时需要谨慎,提倡采用平衡的方法,考虑结扎和缝合等传统方法,这样可以降低此类并发症的风险。持续报告和进一步研究对于更好地了解扁桃体切除术后霍纳综合征背后的机制和改善患者预后至关重要。
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