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Sympathicotomy affects cutaneous blood flow, temperature, and sympathicus‐mediated reflexes
Author(s) -
Koskinen L.O. D.,
Blomstedt P.
Publication year - 2008
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.2008.01046.x
Subject(s) - reflex , medicine , blood flow , hyperhidrosis , anesthesia , brachial artery , provocation test , skin temperature , middle cerebral artery , sympathectomy , surgery , cardiology , blood pressure , biomedical engineering , ischemia , alternative medicine , pathology
Objective – To study the sympathetically mediated effects of transthoracic endoscopic sympathicotomy (TES) in the treatment of severe primary palmar hyperhidrosis. Materials and methods – The effects of TES, on sympathetic ganglia at the thoracic level of 2–3, finger blood flow, temperature, and on heat and cold provocation were investigated. Middle cerebral artery (MCA) blood flow velocities were studied by transcranial Doppler. Results – The finger blood flow increased by about 700% after TES and finger temperature by 7.0 ± 0.5°C. Several autonomic reflexes were dramatically affected. A finger pulp‐shrinking test showed a major decrease after surgery. MCA mean blood flow velocities were not affected by TES. Conclusions – Besides the high success rate of good clinical effect of TES on palmar hyperhidrosis, major effects on local blood flow and temperature are elicited by TES. Complex autonomic reflexes are also affected. The patient should be completely informed before surgery of the side effects elicited by TES.