Impact of T3 thoracoscopic sympathectomy on pupillary function: a cause of partial Horner’s syndrome?

Abstract

T3 sympathectomy leads to subclinical pupillary dysfunction with a tendency for miosis, even though this impairment is not generally evident on standard physical examination or reported by patients. This subclinical dysfunction may be caused by injury to an undefined group of presympathetic nerve cell axons in caudocranial direction that communicate with the cervical sympathetic ganglia and whose function is mydriatic pupillary innervation.

Impact of T3 thoracoscopic sympathectomy on pupillary function: a cause of partial Horner’s syndrome?

“…We compliment Dr. Ramos et al [1] for their important clinical observation. The observation of a partial Horner's syndrome raises the question of the nervous pathways responsible for each of the three components of this triad.…”

Neuro-ophthalmology Annual Review

“…11 Patients with symptomatic palmar hyperhidrosis treated with thoracic (T3) sympathectomies also developed asymptomatic HS. 12 Ophthalmologists should be aware of the potential adverse effect of this procedure to avoid unnecessary additional testing in these patients.…”