Many studies have shown that there s no relationship between the sweating amount of hands and compensatory areas. In addition, reflex sweating is not found on lumbar sympathectomy for pure Hyperhidrosis plantaris. Why are there different postoperative responses between thoracic and lumbar sympathetic surgeries? Is traditional consideration of sympathetic innervation wrong?
New concepts and classifications of sympathetic disorders proposed can explain all postoperative phenomena in sympathetic surgery. We believe that they will become standard rules in sympathetic surgery.
Sweating after sympathetic surgery is a reflex cycle between the sympathetic system and the anterior portion of the hypothalamus according to our investigations.
Reflex sweating will not happen if hand sweating can be stopped without interrupting sympathetic tone to the human brain. We proved clinically from nervous mapping
that neither T2 nor T3, but t4 and lower ganglia provide the major sympathetic
innervation to hands. Major sympathetic fibers at the levels of T3 and
above innervate head and neck. Few or none from T2 and TS innervate the hands while the
fibers from T4 must definitely pass through T2 and TS to innervate hands. This is the
reason why T2-sympatnetic procedures can treat hyperhidrosis but with higher I
incidence and degree of reflex sweating. Thus, we know that ESB4 can treat
hyperhidrosis palmaris without interrupting sympathetic tone to the head
and neck, therefore no reflex sweating is predicted on ESB4 cases.
The Base of Designing New Procedures for Different Indications in Sympathetic Surgery Chien-Chih Lin, M.D., *Timo Telaranta, M. D. Surgical Departments, Tainan Municipal Hospital Tainan, Taiwan; *Pnvatix Clinic, Tampere, Finland Presentations at the 4th International Symposium on Sympathetic Surgery
