The amount of compensatory sweating depends on the patient, the damage that the white rami communicans incurs, and the amount of cell body reorganization in the spinal cord after surgery.
Other potential complications include inadequate resection of the ganglia, gustatory sweating, pneumothorax, cardiac dysfunction, post-operative pain, and finally Horner’s syndrome secondary to resection of the stellate ganglion.
www.ubcmj.com/pdf/ubcmj_2_1_2010_24-29.pdf

After severing the cervical sympathetic trunk, the cells of the cervical sympathetic ganglion undergo transneuronic degeneration
After severing the sympathetic trunk, the cells of its origin undergo complete disintegration within a year.
http://onlinelibrary.wiley.com/doi/10.1111/j.1439-0442.1967.tb00255.x/abstract

Friday, October 3, 2008

11 of 72 patients were not able to accept the severe compensatory (reflex) sweating

Compensatory hyperhidrosis is the most common complication and the major reason for patient dissatisfaction with the procedure. In a recent report on the complications experienced by 72 patients with palmar hyperhidrosis treated with transthoracic endoscopic sympathectomy, all patients except one complained of compensatory hyperhidrosis, with 41.7% complaining of moderate hyperhidrosis and 43.1% severe! In this study, 11 patients were not able to accept the consequences of compensatory hyperhidrosis, even though their palms had become dry postoperatively. Compensatory hyperhidrosis following sympathectomy can be far more life disrupting than palmar hyperhidrosis in that afflicted individuals may have to change sweat-soaked clothing five or six times per day. Moran states it quite succinctly: Complications related to the surgical approach, such as Horner's syndrome, brachial plexus injuries, pneumothorax, and painful scars may occur, while following sympathectomy compensatory hyperhidrosis is usual and hyperhidrosis may recur.

TREATMENT OF HYPERHIDROSIS

Lewis P. Stolman MD, FRCP(C)
University of Medicine and Dentistry of New Jersey, New Jersey Medical School; and the Dermatology and Laser Center of Northern New Jersey, Livingston, New Jersey
Dermatologic Clinics
Volume 16 • Number 4 • October 1998