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ORIGINAL RESEARCH article

Front. Ophthalmol.
Sec. Neuro-Ophthalmology Disorders
Volume 4 - 2024 | doi: 10.3389/fopht.2024.1497845

Computed Tomography-Based Investigation of Degenerative Neural Cervicothoracic Foraminal Stenosis as a Potential Mechanism for Horner Syndrome

Provisionally accepted
Joshua Ong Joshua Ong 1*Mariko Kurokawa Mariko Kurokawa 2Sangeeta Khanna Sangeeta Khanna 1Lindsey B De Lott Lindsey B De Lott 1Ryo Kurokawa Ryo Kurokawa 2Aseem Sharma Aseem Sharma 2
  • 1 Department of Ophthalmology and Visual Sciences, School of Medicine, Michigan Medicine, University of Michigan, Ann Arbor, United States
  • 2 Michigan Medicine, University of Michigan, Ann Arbor, Michigan, United States

The final, formatted version of the article will be published soon.

    To investigate presence and/or severity of cervicothoracic foraminal stenosis between C7-T3 segments could account for Horner syndrome otherwise deemed to be idiopathic in nature. This study was an IRB-approved, retrospective study that included 28 patients [Mean ± Standard Deviation) age: 54.5 ± 18.7) years] with confirmed diagnosis of Horner syndrome, absence of any identifiable cause, and availability of neck CT/ CT angiogram obtained within 6 months of the diagnosis. A neuroradiologist masked to the laterality of Horner syndrome reviewed CT scans, documenting presence/ severity of foraminal stenosis at C7-T1, T1-2, and T2-3 levels on a 4-point Likert scale defined as 0: None, 1: Mild, 2: Moderate, 3: Severe narrowing, with grades 1, 2, and 3 signifying <1/3rd , 1/3rd-2/3rd , and >2/3rd stenosis from the expected normal foraminal dimension. Foraminal stenosis was present ipsilateral to the side of Horner syndrome in 4 (14.3%) patients and on contralateral side in 5 (17.8%) patients. No significant difference in the extent of ipsilateral and contralateral foraminal stenosis was present at C7-T1 (p= 0.66), T1-2 (p=0.32), or T2-3 (p= 0.75) levels. Mean ipsilateral (0.33±1.0) and contralateral (0.33±1.1) Cumulative foraminal stenosis scores were not significantly different (p=1). Mean maximum foraminal stenosis scores ipsilateral (0.22 ± 0.59) and contralateral (0.30±0.81) to the side of Horner syndrome were also comparable (p=0.54). With low prevalence of foraminal stenosis at C7-T3 segments and with equivalent prevalence and severity of foraminal stenosis ipsilateral and contralateral to the side of Horner syndrome, foraminal stenosis is unlikely to be a common causative mechanism for Horner syndrome.

    Keywords: Horner Syndrome, Degenerative Foraminal Stenosis, computed tomography, computed tomography angiography, Neural Cervicothoracic Foraminal Stenosis

    Received: 17 Sep 2024; Accepted: 05 Dec 2024.

    Copyright: © 2024 Ong, Kurokawa, Khanna, De Lott, Kurokawa and Sharma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Joshua Ong, Department of Ophthalmology and Visual Sciences, School of Medicine, Michigan Medicine, University of Michigan, Ann Arbor, United States

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