One case of secondary Horner syndrome in a military pilot re-eligible for flight after treatment and literature review

ZHANG Xiang; ZHANG Min; XUE Junhui; WANG Yusheng; WANG Xiaocheng; ZHENG Jianyong; CHEN Tao

doi:10.3969/j.issn.2097-1753.2025.05.024

Abstract：Objective: To explore the aviation medical examination methods for secondary Horner syndrome in military pilots. Methods: A retrospective analysis was conducted on the diagnosis, treatment, and aviation medical examination of a military pilot who developed Horner syndrome after thyroid cancer surgery, along with a review of relevant literature. Results: In May 2021, this military pilot underwent radical thyroid cancer surgery and subsequently developed Horner syndrome. After five months of oral neurotrophic drug treatment, there was no significant improvement. After multidisciplinary consultation, the patient continued neurotrophic drug treatment while adding traditional Chinese medicine treatments such as acupuncture and cupping therapy. One month later, the symptoms significantly improved. During the aviation medical examination discussion, the focus was on the risk of thyroid cancer recurrence and the possible impact of Horner syndrome on visual function. Based on the results of binocular visual field, dark adaptation, and visual electrophysiology tests, combined with thyroid ultrasound and thyroid function test results, a conclusion of flight eligibility was finally given. After discharge, the patient continued to take thyroid hormone tablets and neurotrophic drugs, along with traditional Chinese medicine treatment. As of April 2024, the patient has safely flown for more than two years, and the symptoms of Horner syndrome have largely disappeared. Conclusion: For military pilots who develop Horner syndrome after thyroid cancer surgery, combining neurotrophic drugs with traditional Chinese medicine treatment can help promote recovery and shorten the course of the disease. The symptoms of Horner syndrome have largely disappeared, and the thyroid ultrasound and thyroid function meet the aviation medical examination standards. Visual function does not affect the requirements of the flight job, and it is considered appropriate to grant a flight qualification conclusion.