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

Wednesday, November 4, 2009

Acute Postoperative Shingles After Thoracic Sympathectomy for Hyperhidrosis

Shingles secondary to reactivation of a previous varicella-zoster virus infection has been reported to develop within surgical wounds and after trauma. We report the case of a 17-year-old girl with history of chicken pox in childhood who had acute postoperative shingles develop along the T3-T4 dermatomes after thoracic sympathectomy for hyperhidrosis.
Other possible explanations for the development of shingles in this patient include (1) the reactivation of the old varicella-zoster virus in the dorsal root ganglia by manipulation of the sympathetic chain through preoperative and postoperative ganglionic axonal connections between the denervated sympathetic ganglia and the T3 and T4 dorsal root ganglia, or (2) reactivation of the virus by direct pressure of the thoracoscopic instruments on the third and fourth intercostal nerve bundles.
http://ats.ctsnetjournals.org/cgi/content/full/78/6/2159