Thoracoscopic Sympathectomy for Hyperhidrosis

Neurosurgery ◽  
2010 ◽  
Vol 67 (3) ◽  
pp. 652-657 ◽  
Author(s):  
Scott D. Wait ◽  
Brendan D. Killory ◽  
Gregory P. Lekovic ◽  
Francisco A. Ponce ◽  
Kathy J. Kenny ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Well Being ◽  
Sympathetic Chain ◽  
Horner’S Syndrome ◽  
Compensatory Sweating ◽  
Horner's Syndrome ◽  
Thoracoscopic Sympathectomy ◽  
Safe Treatment ◽  
Female Patients

Abstract BACKGROUND Hyperhidrosis (HH) profoundly affects a patient's well-being. OBJECTIVE We report indications and outcomes of 322 patients treated for HH via thoracoscopic sympathectomy or sympathotomy at the Barrow Neurological Institute. METHODS A prospectively maintained database of all patients who underwent sympathectomy or sympathotomy between 1996 and 2008 was examined. Additional follow-up was obtained in clinic, by phone, or by written questionnaire. RESULTS A total of 322 patients (218 female patients) had thoracoscopic treatment (mean age 27.6 years; range, 10–60 years). Mean follow-up was 8 months. Presentations included HH of the palms (43 patients, 13.4%), axillae (13 patients, 4.0%), craniofacial region (4 patients, 1.2%), or some combination (262 patients, 81.4%). Sympathectomy and sympathotomy were equally effective in relieving HH. Palmar HH resolved in 99.7% of patients. Axillary or craniofacial HH resolved or improved in 89.1% and 100% of cases, respectively. Hospital stay averaged 0.5 days. Ablating the sympathetic chain at T5 increased the incidence of severe compensatory sweating (P = .0078). Sympathectomy was associated with a significantly higher incidence of Horner's syndrome compared with sympathotomy (5% vs 0.9%, P = .0319). Patients reported satisfaction and willingness to undergo the procedure again in 98.1% of cases. CONCLUSION Thoracoscopic sympathectomy is effective and safe treatment for severe palmar, axillary, and craniofacial HH. Ablating the T5 ganglion tends to increase the severity of compensatory sweating. Sympathectomy led to a higher incidence of ipsilateral Horner's syndrome compared with sympathotomy.

scholarly journals Rhabdomyosarcoma of the middle ear cavity presenting with Horner’s syndrome

2019 ◽  
Vol 101 (1) ◽  
pp. e8-e10
Author(s):  
SM Hayes ◽  
TC Biggs ◽  
JH Bird ◽  
WP Hellier
Keyword(s):  
Middle Ear ◽  
Striated Muscle ◽  
Proton Beam Therapy ◽  
Malignant Tumour ◽  
Horner’S Syndrome ◽  
Horner's Syndrome ◽  
Carotid Canal ◽  
Ear Infections ◽  
Disease Free

Rhabdomyosarcoma is a rare malignant tumour of striated muscle accounting for 3% of all primary soft tissue tumours of the middle ear cavity. We describe a unique case of a rhabdomyosarcoma of the middle ear cavity in a four-year-old boy, presenting as an otherwise asymptomatic ipsilateral Horner’s syndrome. This case involved tumour erosion through the tensor tympani semicanal, accessing the carotid canal and the sympathetic plexus running through it. This child was treated successfully with chemotherapy and proton beam therapy, and remains disease free at six years of follow-up. This case highlights the importance of investigating patients with non-resolving ear infections, polyps or granulation tissue.

Benign thyroid swelling presenting as Horner’s syndrome

2020 ◽  
Vol 13 (12) ◽  
pp. e235313
Author(s):  
Sherin K Shaji ◽  
Jacquline Chan ◽  
Churunal Hari
Keyword(s):  
Pressure Effect ◽  
Sympathetic Chain ◽  
Horner’S Syndrome ◽  
Nerve Supply ◽  
Common Condition ◽  
Horner's Syndrome ◽  
First Case ◽  
Cervical Sympathetic ◽  
Thyroid Swelling ◽  
Benign Thyroid

Horner’s syndrome is a rare neurological condition seen in association with the disruption in the sympathetic nerve supply. Thyroid swelling is a common condition but rarely causes cervical sympathetic chain compression. We describe a case of a 54-year-old man who presented with Horner’s syndrome secondary to a benign thyroid nodule with pressure effect on the sympathetic chain. An association between thyroid pathologies and Horner’s syndrome has been mentioned previously, however, to our knowledge, this is the first case of Horner’s syndrome being the initial presentation for an underlying benign thyroid swelling.

Current subjective state of health, and longitudinal psychological well-being over a period of 10 years, in a cohort of adults with congenital cardiac disease

2005 ◽  
Vol 15 (2) ◽  
pp. 168-175 ◽  
Author(s):  
Elisabeth H. M. van Rijen ◽  
Elisabeth M. W. J. Utens ◽  
Jolien W. Roos-Hesselink ◽  
Folkert J. Meijboom ◽  
Ron T. van Domburg ◽  
...  
Keyword(s):  
Cardiac Disease ◽  
Bodily Pain ◽  
Well Being ◽  
State Of Health ◽  
Psychological Well Being ◽  
Subjective State ◽  
Female Patients ◽  
Congenital Cardiac Disease ◽  
Psychological Examination

Objective: To examine the current subjective state of health, and the longitudinal course of psychological well-being, in adult patients with congenital cardiac malformations. Methods: Our study concerns the second follow-up of a cohort of patients with congenital cardiac malformations. We examined 362 consecutive patients, aged from 20 to 46 years, who underwent surgical procedures for treatment of congenital cardiac disease between 1968 and 1980, specifically for treatment of atrial and ventricular septal defects, tetralogy of Fallot, transposition, and pulmonary stenosis. The patients were submitted to extensive medical and psychological examination. During psychological examination, in which all patients were seen by the same psychologist (EvR), patients filled in questionnaires concerning their current subjective state of health, using the 36-item Short Form Health Survey (SF-36), and psychological well-being, answering the Heart Patients Psychological Questionnaire. The data we acquired at their first follow-up was used to measure the longitudinal course of psychological well-being over the intervening period of 10 years. Results: When compared to a reference group, the patients assessed their state of health less favourably concerning physical functioning, but more favourable with regard to social functioning, bodily pain, and limitations of role due to emotional problems. Younger female patients reported more limitations of role due to physical functioning than did the female patients who were older. Patients with transposition showed a negative trend for their subjective state of health, but reported the least bodily pain. Within the overall group of patients, displeasure had increased, while social inhibition had decreased, over the intervening period of 10 years. Conclusion: Extra attention should be paid to the subjective experiences of young female patients with congenital cardiac disease. The patients with transposed arterial trunks seem overall to experience poorer physical health.

CASE REPORT: POURFOUR DU PETIT SYNDROME IN A PATIENT WITH MIGRAINE

2015 ◽  
Vol 86 (11) ◽  
pp. e4.169-e4
Author(s):  
Aseel Al-Ansari ◽  
Richard Jon Llewellyn Walters
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Sympathetic Chain ◽  
Horner’S Syndrome ◽  
Eyelid Retraction ◽  
Horner's Syndrome ◽  
Blurred Vision ◽  
History Of ◽  
Cervical Sympathetic ◽  
Unusual Symptoms

A 45-year old woman presented with a twelve-month history of intense migraines. She described episodes of blurred vision in association with the headaches, during which she invariably found that one or other of her pupils became dilated with a degree of eyelid retraction on the affected side. These unusual symptoms resolved spontaneously with improvement of the headache.After exclusion of a lesional cause with brain and neck imaging, we concluded that her symptoms were secondary to autonomic dysfunction in relation to her headache.Horner's syndrome is due to paralysis of the ipsilateral cervical sympathetic chain and comprises ptosis, miosis, enopthalmos and anhidrosis. A Reverse Horner's syndrome, otherwise known as Pourfour du Petit, in theory, is the opposite, and comprises eyelid retraction, mydriasis and hyperhidrosis. Where documented, it is attributed to irritation, rather than complete deficiency of the ipsilateral sympathetic chain. Previous case reports have shown that Pourfour du Petit can occur due to the same mechanisms as a Horner's syndrome. In only one other case report has it been described as an autonomic feature in relation to headache.

Cervical Sympathetic Chain Schwannoma: An Uncommon Cause of Horner's Syndrome

2012 ◽  
Vol 70 (4) ◽  
pp. 851-855 ◽  
Author(s):  
Laura Villanueva-Alcojol ◽  
Florencio Monje ◽  
Raul Gonzalez-García ◽  
David Gonzalez Ballester ◽  
Jesús Mateo Arias ◽  
...  
Keyword(s):  
Sympathetic Chain ◽  
Horner’S Syndrome ◽  
Horner's Syndrome ◽  
Cervical Sympathetic Chain ◽  
Cervical Sympathetic

scholarly journals Horner’s syndrome caused by the cervical sympathetic chain schwannoma

2019 ◽  
Vol 29 (1) ◽  
pp. 73-78
Author(s):  
Yusuke Kiyokawa ◽  
Hiroaki Kawabe ◽  
Nobuaki Koide ◽  
Yumiko Tateishi ◽  
Akihisa Tasaki ◽  
...  
Keyword(s):  
Sympathetic Chain ◽  
Horner’S Syndrome ◽  
Horner's Syndrome ◽  
Cervical Sympathetic Chain ◽  
Cervical Sympathetic

Biportal thoracoscopic sympathectomy for palmar hyperhidrosis in adolescents

2010 ◽  
Vol 6 (2) ◽  
pp. 183-187 ◽  
Author(s):  
Scott D. Wait ◽  
Brendan D. Killory ◽  
Gregory P. Lekovic ◽  
Curtis A. Dickman
Keyword(s):  
Hospital Stay ◽  
Surgical Outcomes ◽  
Chest Tube ◽  
Intraoperative Complications ◽  
Senior Author ◽  
Palmar Hyperhidrosis ◽  
Thoracoscopic Sympathectomy ◽  
Tube Drainage

Object Palmar, axillary, and plantar hyperhidrosis is often socially, emotionally, and physically disabling for adolescents. The authors report surgical outcomes in all adolescents treated for palmar hyperhidrosis via bilateral thoracoscopic sympathectomy at the Barrow Neurological Institute by the senior author. Methods A prospectively maintained database of all adolescent patients undergoing bilateral thoracoscopic sympathectomy between 1998 and 2006 (inclusive) was reviewed. Additional follow-up was obtained as needed in clinic or by phone or written questionnaire. Results Fifty-four patients (40 females) undergoing bilateral procedures were identified. Their mean age was 15.4 years (range 10–17 years). Average follow-up was 42 weeks (range 0.2–143 weeks). Hyperhidrosis involved the palms alone in 10 patients; the palms and axilla in 6 patients; the palms and plantar surfaces in 17 patients; and the palms, axilla, and plantar surfaces in 21 patients. Palmar hyperhidrosis resolved completely in 98.1% of the patients. Resolution or improvement of symptoms was seen in 96.3% of patients with axillary and 71.1% of those with plantar hyperhidrosis. Hospital stay averaged 0.37 days with 68.5% of patients discharged the day of surgery. One patient experienced brief intraoperative asystole that resolved with medications and had no long-term sequelae. Otherwise, no serious intraoperative complications occurred. No patient required chest tube drainage. The percentage of patients who reported satisfaction and willingness to undergo the procedure again was 98.1%. Conclusions Biportal, bilateral thoracoscopic sympathectomy is an effective and low-morbidity treatment for severe palmar, axillary, and plantar hyperhidrosis.

scholarly journals Thorascopic Sympathectomy Performed Using Laser

2008 ◽  
Vol 90 (2) ◽  
pp. 142-145 ◽  
Author(s):  
SA Black ◽  
FGM Taylor ◽  
MH Russell ◽  
R Ariga ◽  
MH Thomas
Keyword(s):  
Palmar Hyperhidrosis ◽  
Tissue Loss ◽  
Horner’S Syndrome ◽  
Horner's Syndrome ◽  
Patients Âgés ◽  
Facial Blushing ◽  
Single Operator ◽  
Digital Ischaemia ◽  
Two Stages

INTRODUCTION Thorascopic sympathectomy is accepted as an effective treatment for palmar hyperhidrosis, facial blushing and to a lesser extent for digital ischaemia and axillary hyperhidrosis. PATIENTS AND METHODS Data were collected retrospectively on patients undergoing thorascopic sympathectomy at St Peter's Hospital between 1987 and 2006. Patients were followed up by telephone interview. RESULTS A total of 233 thorascopic sympathectomy procedures were performed by a single operator in 123 patients. Ages ranged from 9–71 years and 75 were women. In patients, 105 had a bilateral and 13 a unilateral procedure, 5 patients had a bilateral procedure performed in two stages. In 6 upper limbs, the procedure could not be done. Overall, 110 patients (90%) had the procedure performed for palmar hyperhidrosis, 8 (6%) for facial blushing and in 5 (4%) patients the operation was performed for digital ischaemia with tissue loss. There were no deaths and all patients were discharged on day 1 following the procedure. Complications included bleeding (2), pulmonary oedema (1) and failed procedure (2); however, no incidences of Horner's syndrome occurred. Only 40 of 123 (32.5%) patients gave follow-up information. Of this small group, 33 of 40 (83%) were cured, 4 of 40 (10%) were better, 2 of 40 (5%) were unchanged and 1 patient was worse. Only 22 out of 40 (55%) of these patients were troubled by compensatory sweating, with only 4 of 40 (10%) reporting this as a major problem. CONCLUSIONS Thorascopic sympathectomy is safe and can be carried out as a single bilateral procedure in the majority of cases. The laser allows the use of a single port, requires less dissection than surgical or clipping techniques, is more precise than diathermy and may be less likely to cause a Horner's syndrome.

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