Can Thoracic Sympathetic Nerve Damage Be Reversed?

Erol, Mehmet Muharrem; Salcı, Hakan; Melek, Hüseyin; İlhan, Tuncay; Özfiliz, Nesrin; Bayram, Ahmet Sami; Gebitekin, Cengiz

doi:10.1055/s-0034-1390046

Cited by 3 publications

(5 citation statements)

References 12 publications

(12 reference statements)

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“…[8] In this electrophysiological study, we observed that the transmission of stimulation in the sympathetic nerve occurred again shortly after removal of the clip. In addition, in the histological results of our previous study, [6] the regenerative histological process and nerve conduction continued after the removal of the clip. Surgical intervention to T2 sympathetic nerve ganglion is widely used in the treatment of palmar hyperhidrosis.…”

Section: Discussionmentioning

confidence: 62%

“…In the treatment of primary hyperhidrosis, the nerve is clipped with titanium clips to prevent the conduction of sympathetic nerve stimulation. [6,7,11] In a study, although 11% of patients had relapse over a five-year period, the clinical outcomes were similar to resection (sympathectomy) or sympathetic chain transection (sympatheticotomy). [17] It is well documented that the use of metal clips is preferred over other methods, since it is theoretically thought that nerve stimulation can be achieved by removing the clips, when undesirable side effects develop.…”

Section: Discussionmentioning

confidence: 99%

“…Thoracic sympathectomy (TS) is a surgical procedure performed to reduce various sympathetic disorders by reducing vasomotor tone and decreasing peripheral vascular resistance. [1] Indications for TS are palmar hyperhidrosis, flushing, [1][2][3][4][5][6][7][8] cold intolerance, reflex sympathetic dystrophy, distal occlusions of the arms, long QT syndrome, peripheral vascular insufficiency, axillary sweating, angina pectoris, and Raynaud's syndrome. [1][2][3][4][5]7,9,10] Thoracic sympathectomy is performed as resection, ablation or division of the thoracic sympathetic chain to prevent adrenergic effect of the arms.…”

mentioning

confidence: 99%

“…[4,5,7,8] If the complication occurs, the metal clips should be removed and nerve conduction should be restored. [6,8,17] In the present study, we aimed to examine the efficacy of clipping in TS based on electrophysiological evaluation and to investigate whether nerve conduction could be formed by collateral nerve extensions as a result of the clipping procedure to different levels of sympathetic nerve.…”

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confidence: 99%

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Electrophysiological evaluation of efficacy of clipping in thoracic sympathectomy: An experimental cadaveric study

Salcı

Acar

Taşkapılıoğlu

et al. 2020

Turk Gogus Kalp Dama

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Background: This study aims to examine the efficacy of clipping in thoracic sympathectomy based on electrophysiological evaluation and to investigate whether nerve conduction can be formed by collateral nerve extensions as a result of the clipping procedure to different levels of sympathetic nerve. Methods: Newly sacrificed six sheep hemithoraces were studied between August 2016 and October 2016. Thoracic sympathectomy was performed by clipping at T2, T3, T4, and T5 sympathetic chain levels and their branches. Electrophysiological studies were performed with an electromyography device and the filter range was 1 Hz with 20 µV/D amplification. Signals were processed digitally; bipolar subdermal needle electrodes were used as stimulation and recording electrodes (Ø 0.75 mm); and the ground electrode was placed in the intercostal muscle where the thoracic sympathectomy procedure would be performed. Results: Electrophysiological evaluations showed that clips placed on the main sympathetic chain branches and sympathetic nerve trunk prevented collateral impulse conduction and stimulated potentials were not recorded. However, sympathetic conduction continued at the same intensity after removal of the clips. Conclusion: Clipping of different regions of the sympathetic nerve provides electrophysiological blockage of the sympathetic nerve, and conduction continues after removal of the clips. However, the short- and long-term postoperative electrophysiological results after removal of the clips over the sympathetic nerve is still a question mark.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Electrophysiological evaluation of efficacy of clipping in thoracic sympathectomy: An experimental cadaveric study

Salcı

Acar

Taşkapılıoğlu

et al. 2020

Turk Gogus Kalp Dama

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“…Although the mechanism of thoracic sympathetic chain regeneration is still not clear, sympathectomy and sympathicotomy are generally considered to be irreversible procedures due to the resection of sympathetic chain in contrast to other procedures as sympathetic clipping where the continuity of the sympathetic trunk is maintained. In an experimental study, Erol and colleagues [17] found a recovery of sympathetic nerve function after postsurgical removal of clips due to reconstitution of myelin, whereas no signs of sympathetic regeneration were found when the sympathetic chain was excised or remained clipped. Hemodynamic studies on patients who have undergone cardiac transplantation did not show any evidence of cardiac reinnervation up to 9 years after operation [18].…”

Section: Commentmentioning

confidence: 99%