ANHIDROSIS AFTER SYMPATHETOMY

Prediction: Thoracic sympathectomy will cause anhidrosis in the denerved area.

Empirical Status: Confirmed.

Anhidrosis

Sweat glands are controlled almost entirely via the sympathetic nervous system, and do not have parasympathetic innervation at all. Unlike most other sympathetic nerve terminals, the receptors in sweat glands are activated by acetylcholine, not norepinephrine. It is possible that sweat glands can be activated locally to a small degree by catecholamines in the blood, but for practical purposes sympathectomy renders sweat glands permanently non-functional in the denerved area. This dysfunction is called "anhidrosis".

Anhidrosis is considered dangerous, as we learn from the WebMD dictionary:

Anhidrosis: Not sweating. From the Greek an- meaning a lack of + hidros meaning sweat = lack of sweat. The inability to sweat may seem a blessing but it is not, since to sweat is to be able to stay cool. Anhidrosis creates a dangerous inability to tolerate heat. (WebMD dictionary)

In one clinical trial, ETS patients subjectively described the sensation of anhidrosis as “disturbing”.

“Patients undergoing T2-T4 resection often experience anhidrosis from the nipple line upwards which has been disturbing for several individuals.” (Fischel et al. 2003)


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