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

Thursday, May 8, 2008

Sympathectomy in the treatment of vulvodynia -

Third, four subjects having successful blocks had laparoscopic presacral neurectomy, yielding one durable success, two transient remissions, and one nonresponse. We investigated open dissection instead. Six patients with disabling pain (including two who failed laparoscopic procedures) underwent complete pelvic sympathectomy (superior hypogastric plexus and lateral chains). Five have no vulvar pain and one has a bizarre but generally transient pain (sympathalgia).58 Fourth, since the peripheral sympathetic nerve fibers are primarily an efferent system, it has been postulated that the afferent limb of this reflex arc is provided by "sensitization" of otherwise silent somatic C fibers that travel in the adventitia of musculocutaneous blood vessels .58, 71 Sensitization means that the polymodal nociceptors (pain receptors) on these C fibers can be fired by noradrenalin, rather than acetylcholine, hence producing a pain loop maintained by activity within the adjacent sympathetic efferents. Preliminary experience with a quantitative thermal testing machine in vulvodynia patients has shown microneurographic patterns of chronic C fiber inflammation.

http://www.vulvodynia.com.au/articles/002.htmlhttp://www.vulvodynia.com.au/index.html

Sympathectomy for chronic inflammation of the pancreas - Brisbane, AU

The operation, a thoroscopic
sympathectomy, is not a particu-
larly common procedure, but for
patients suffering from chronic
inflammation of the pancreas it
provides significant pain relief.
Thoroscopic sympathectomy
surgery is performed at the Royal
Brisbane and Women’s Hospital
about 15 to 20 times a year.

An official publication of Queensland Health Vol 9 No 1 February 2004

The hypothalmus also regulates body temperature

Question:

The hypothalamus controls hunger, thirst, [1] fatigue, anger, and circadian cycles.It also regulates body temperature. Can the subsequent Compensatory Sweating that follows after Symoathectomy be a symptom of the dysregulated hypotalamus. Can the severity of the CS be a reflection of the extent of the damage?

The acute effect of superior cervical ganglionectomy

The acute effect of superior cervical ganglionectomy (SCGx) on the pituitary-thyroid axis was examined in rats subjected to surgery 3-24 h earlier. SCGx caused an abrupt decline in thyroid norepinephrine content (an index of degeneration of sympathetic nerve terminals) to 5-10% of controls between 8 and 16 h. Rats subjected to SCGx 14 h earlier exhibited a significant depression of thyroid 131I uptake, total and free serum T4 levels and serum TSH levels.
Efferent Neuroendocrine Pathways of Sympathetic Superior Cervical Ganglia
Early Depression of the Pituitary-Thyroid Axis after Ganglionectomy
D.P. Cardinali, M.A. Pisarev, M. Barontini, G.J. Juvenal, R.J. Boado, M.I. Vacas
Neuroendocrinology 1982;35:248-254

The results further support that a regional sympathectomy causes qualitative alterations in bone modeling and remodeling, leading to bone resorption.

To assess the effect of a local sympathectomy on bone metabolism, the effect of a unilateral superior cervical ganglionectomy (Gx) on growth and bone mineral content and density of the ipsi- and contralateral mandibles was examined in female rats. A significant increase in the hemi-mandibular bone ipsilateral to Gx was found as compared to the contralateral, sham-operated side 30 days, but not 15 days, after surgery. Bone mineral content of the hemi-mandibular bones was significantly lower in the side ipsilateral to Gx in the group of rats killed on the 30th day after surgery. Since no difference in areas between innervated and denervated hemi-mandibles was found, bone mineral density was also significantly lower in the hemi-mandible ipsilateral to Gx. The results further support that a regional sympathectomy causes qualitative alterations in bone modeling and remodeling, leading to bone resorption.

Marta G. Ladizeskya, Rodolfo A. Cutrerab, Verónica Boggiob, Carlos Mautalena and Daniel P. Cardinalib, *

a Sección Osteopatías Médicas, Hospital de Clínicas “José de San Martín”, Argentina

b Departamento de Fisiología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, 7o. Piso, 1121 Buenos Aires, Argentina

Received 27 May 1999;
revised 12 August 1999;
accepted 23 August 1999.
Available online 21 January 2000.

Cervical sympathectomy affects gonadotropin-releasing hormone, luteinizing hormone and testosterone

Therefore, long-term and repeated stellate ganglion block may inhibit the increases of GnRH, LH, and TS secretions induced by continuous light.

Hiroshi Iwama1 Contact Information, Choichiro Tase1, Yoshikazu Tonosaki2 and Yasuo Sugiura2
(1) Department of Anesthesiology, Fukushima Medical College, 1 Hikarigaoka, 960-12 Fukushima, Japan
(2) Department of Anatomy, Fukushima Medical College, 1 Hikarigaoka, 960-12 Fukushima, Japan

Received: 24 August 1994 Accepted: 16 December 1994

Sympathectomy decreases and adrenergic stimulation increases the release of tissue plasminogen activator (t-PA) from blood vessels

Our recent morphologic studies indicated that peripheral nervous system (PNS) adrenergic neurons synthesize, transport, and store the serene protease, tissue plasminogen activator (t-PA) in axon terminals, many of which innervate vessel walls. Sympathoadrenal stimulation induces a surge of t-PA from vessel walls into the blood. The vascular endothelium, which constitutively secretes t-PA into blood also has long been widely assumed to be the principal source of this stress-induced release, but has not been verified as such. A neurologically regulated release from adrenergic stores could thus augment the known constitutive endothelial release. To functionally test this possibility, we quantitated the effects of guanethidine-induced systemic sympathectomy on the basal and stimulated release of t-PA from isolated vessel explants in superfused organ cultures. Moment-to-moment changes in the release rate were plotted from serial assays of the t-PA free activity. The effects of endothelial and adventitial nerve plexus ablations were also tested. Sympathectomy induced 30-50% reductions in t-PA release from both arterial and microvascular explants. An acute release induced by alpha-1 adrenergic receptor stimulations was also strongly suppressed, as were basal levels of the circulating enzyme in vivo. Adventitial and endothelial ablations from normal large vessel explants produced greater reductions than small vessel endothelial ablations. Ganglion electrical stimulation also induced an acute microvascular release in vivo. These and past morphologic findings indicate a physiological infusion of t-PA into the vessel walls, blood, and other innervated matricesby sympathetic neurons. J. Neurosci. Res. 57:680-692, 1999. © 1999 Wiley-Liss, Inc.
Tao Peng 1, Xi Jiang 1, Yafei Wang 1, Arthur Hand 2, Concettina Gillies 1, Robert E. Cone 1, James O'Rourke 1 *
1Department of Pathology, University of Connecticut Health Center, Farmington
2Central Electron Microscope Facility, University of Connecticut Health Center, Farmington
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