Treatment of social phobia by endoscopic thoracic sympathicotomy

Telaranta, Timo

doi:10.1080/11024159850191102

Cited by 47 publications

(36 citation statements)

References 19 publications

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“…Thoracic sympathectomy is a valid treatment option in patients suffering from facial blushing, palmar or axillar hyperhidrosis, and peripheral vascular disease, such as secondary Raynaud's disease [1,2]. Different surgical techniques have been reported, among which thoracoscopic sympathectomy is considered to be the least invasive technique [3][4][5][6][7].…”

Section: Discussionmentioning

confidence: 99%

“…Our technique with a transaxillary single approach may provide better cosmetic effects and less pain, and gives indeed an excellent visualisation of the sympathetic chain up to the first rib. The endoscopic transaxillary access has already been reported [2,3,10] but it usually requires several ports which might adversely influence the outcome regarding discomfort and pain. Clinical assessment 3 months after surgery in our series revealed an uneventful wound healing and an excellent functional and cosmetic result in all patients.…”

Section: Discussionmentioning

confidence: 99%

“…Video-assisted thoracoscopic (VATS) sympathectomy has already been proved to be a simple, safe, reliable, and costeffective therapy in patients with primary hyperhidrosis and/ or facial blushing, offering long-term relief of symptoms [1,2]. This technique has replaced the open transthoracic approach, since it is associated with lesser sequelae.…”

Section: Introductionmentioning

confidence: 99%

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Minimally invasive video-endoscopic sympathectomy by use of a transaxillary single port approach

Lardinois¹

2002

European Journal of Cardio-Thoracic Surgery

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Objectives: This is a prospective study to evaluate the long-term outcome and the value of a transaxillary single port thoracic sympathectomy by use of a modified paediatric cystoresectoscope in a consecutive series of patients with facial blushing and/or hyperhidrosis. Materials and methods: All patients who underwent a thoracic transsection of the sympathetic chain from T2 to T5 by use of a 7-mm single port approach and a modified urologic electroresectoscope between 1996 and 1998 were prospectively analysed regarding postoperative morbidity and outcome (clinical evaluation, visual analogue scale) in order to validate this technique. Results: 37 patients (18 men, 19 women) with an age ranging from 18 to 67 years (mean 34 years) underwent 74 bilateral video-assisted thoracic sympathectomies. The indications for sympathectomy included facial blushing in 32%, hyperhidrosis in 52%, or both in 16% of the patients. Ninety-five percent of the patients were discharged from the hospital on the next day, the 30-day mortality was zero, and there was no conversion to an open procedure. A severe complication with crossed emboli and motor aphasia was noted. A unilateral transient Horner's syndrome was observed in two patients. Three-month follow-up revealed an excellent cosmetic and functional result, with no residual pain. Complete relief of symptoms was observed in 89% and in 100% of the patients with facial blushing and palmar hyperhidrosis, respectively, after a follow-up of 34.5 months. Recurrence of the symptoms after initial regression was noted in 5.7% of the patients 3 years after surgery. Compensatory sweating of the lower extremities was significantly increased in patients with hyperhidrosis and facial blushing; however, sweating of the trunk was only increased in patients with hyperhidrosis. Improvement of quality of life was observed in 94.6% of the patients. Conclusions: Single port thoracoscopic sympathectomy by use of a modified paediatric cystoresectoscope and transsection from T2 to T5 gives an excellent cosmetic and functional outcome, with better results in patients with hyperhidrosis. q

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Minimally invasive video-endoscopic sympathectomy by use of a transaxillary single port approach

Lardinois¹

2002

European Journal of Cardio-Thoracic Surgery

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“…Dr. Telaranta showed that clipping the sympathetic ganglia, via an endoscopic sympathetic block (ESB) at the second thoracic vertebra (T2), could produce psychiatric effects [15][16][17]. It was also noted that social phobias and PTSD share many common features-especially symptoms associated with over activity of the sympathetic nervous system (SNS), such as heart racing, hyper vigilance, and avoidance of painful psychic situations [16].…”

Section: Modulation Of Cervical Sympathetic Ganglions By Minimally Inmentioning

confidence: 99%

Post Traumatic Stress Disorder (PTSD) as an Over Activation of Sympathetic Nervous System: An Alternative View

Lipov¹

2013

J Trauma Treat

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“…[10][11][12][13][14][15][16][17][18][19][20][21][22] This access route, after the surgeon has acquired adequate experience through training in videoassisted thoracoscopy, allows well-directed surgery to be performed, with minimal risk of the disagreeable complications that occurred in the past when the transcervical route was used, as well as the sequelae and scars of classical thoracotomy. [23][24][25][26] In using the transcervical route, injury to the stellate ganglion is in fact very frequent and expected, producing significant sequelae: the so-called Claude-Bernard-Horner syndrome (palpebral ptosis, miosis and enophthalmos).…”

Section: Total 743mentioning

confidence: 99%

Role of video-assisted thoracoscopic sympathectomy in the treatment of primary hyperhidrosis

et al. 2003

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CONTEXT: Essential hyperhidrosis is a frequent disorder causing significant functional impairment. The advent and development of video-assisted thoracoscopic techniques now allows thoracic sympathectomy to be carried out precisely and safety with good results and minimal morbidity. OBJECTIVE: To assess the impact of video-assisted thoracic sympathectomy in patients diagnosed as presenting severe and disabling hyperhidrosis. TYPE OF STUDY: This was a longitudinal study of the clinical course of all hyperhidrosis cases selected for surgery between May 1999 and January 2003. SETTING: Division of Thoracic Surgery, Universidade Federal de São Paulo (UNIFESP). PARTICIPANTS: 743 patients with surgery indicated due to palmar hyperhidrosis (49.8%), palmar-axillary hyperhidrosis (38.1%), craniofacial hyperhidrosis (8.9%) or isolated axillary hyperhidrosis (2.8%). PROCEDURES: Video-thoracoscopic sympathectomy was performed, isolating the second thoracic ganglion (T2) in all patients, with additional sympathectomy of T3 and T4 if necessary. MAIN MEASUREMENTS:The clinical course was followed up via questionnaires, phone calls, letters and statements. Simple questions were asked regarding the disappearance of symptoms and presence and intensity of compensatory sweating. RESULTS: The surgery was regarded as efficient in all cases of palmar hyperhidrosis. In the craniofacial hyperhidrosis cases, partial recurrence of the symptoms occurred in 2 cases (3.0%). Partial recurrence or persistence of symptoms occurred in 20% of the patients with predominantly axillary symptomatology. The compensatory sweating was considered disagreeable or uncomfortable by about 30% of the patients, but it only reached the level of regretting the operation for 3% of them. This occurred more frequently in patients with axillary hyperhidrosis. Ten cases of complications occurred. CONCLUSION: Thoracoscopic sympathectomy provides very good results in most patients, with a very low complication rate. However, the assessment of surgical results using conventional methods is imprecise and inaccurate. Different methodology, including quality of life assessment, must be used for comparing results and providing objective data on the results of this operation.

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Treatment of social phobia by endoscopic thoracic sympathicotomy

Cited by 47 publications

References 19 publications

Minimally invasive video-endoscopic sympathectomy by use of a transaxillary single port approach

Minimally invasive video-endoscopic sympathectomy by use of a transaxillary single port approach

Post Traumatic Stress Disorder (PTSD) as an Over Activation of Sympathetic Nervous System: An Alternative View

Role of video-assisted thoracoscopic sympathectomy in the treatment of primary hyperhidrosis

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