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

Monday, September 8, 2008

A critical analysis and long-term results

Permanent side effects included compensatory sweating in 67.4%, gustatory sweating in 50.7% and Horner's trias in 2.5%. However, patient satisfaction declined over time, although only 1.5% recurred. This left only 66.7% satisfied, and a 26.7% partially satisfied. Compensatory and gustatory sweating were the most frequently stated reasons for dissatisfaction. Individuals operated for axillary hyperhidrosis without palmar involvement were significantly less satisfied (33.3% and 46.2%, respectively).

F Herbst, E G Plas, R Függer, and A Fritsch
Department of Surgery, University of Vienna, Austria.
Ann Surg. 1994 July; 220(1): 86–90.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1234291

Sympathectomy was never evaulated for effectiveness or safety

No systematic reviews, meta-analyses, or clinical trials that evaluated the
effectiveness of endoscopic thoracic sympathectomy for treating facial
blushing were identified. However, we have identified four case series
related to the request (Drott et al. 1998, Rex et al. 1998, Telaranta 1998,
Yilmaz et al. 1996). These studies were conducted in three countries
(Sweden, Finland and the Netherlands).

The four case series were not critically appraised because they are prone
to bias and have significant methodological problems. These studies
represent level IV evidence according to the NHMRC criteria and one
should not draw firm conclusions from their findings.

To date, the benefits or side effects associated with endoscopic thoracic
sympathectomy for treating facial blushing have not been properly
evaluated and reported.

Centre for Clinical Effectiveness

Omar Ahmed PhD,
Monash University, 2001
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