Percutaneous Phenol Block of the Upper Thoracic Sympathetic Chain with Computed Tomography Guidance

Abstract

Twenty-one percutaneous neurolyses of the upper thoracic sympathetic chain were performed in 12 patients with CT guidance by a single injection of 1 to 3 ml of phenol at the level of Th3. Results were assessed after a follow-up period varying from 4 to 33 months. Three patients with hyperhidrosis had immediate and complete disappearance of symptoms, but only one patient remained dry. In 1/14 procedures done for Raynaud's disease symptoms disappeared or diminished. These long term results are competitive with surgery. Three transitory Homer syndromes and one pneumothorax occurred.

Phenol Neurolysis for Severe Chronic Nonmalignant Pain: Is the Old also Obsolete?

“…Phenol sympatholysis is a recognized technique for the treatment of advanced vascular disease [9], Raynaud's disease [10], and hyperhidrosis [11]. Phenol is also useful for postoperative analgesia and for prolonged analgesia after trauma or postherpetic neuralgia.…”

Radiofrequency upper thoracic sympathectomy in the treatment of critical upper limb ischemia - a case series

“…The administration of a total volume of 6 ml of 6% phenol in two levels there is however a high risk of damage of the surrounding structures by the neurolytic agent 20 . This method was abandoned after the introduction of RF thermolysis.…”

Treatment of Focal Hyperhidrosis

“…Sympathectomy can be carried out nonsurgically with the use of computed tomography–guided injection of phenol or alcohol. 55 Surgical intervention can be performed via an open incision or the more popular endoscopic technique. In endoscopic thoracic sympathectomy (ETS), the sympathetic ganglia are destroyed by excision, ablation, or titanium clipping.…”