Upper thoracic sympathetic chain neurolysis under CT guidance. A two year follow-up in patients with palmar and axillary hyperhidrosis(194 visite) Romano M, Giojelli A, Mainenti PP, Tamburrini O, Salvatore M
Radiol Med (ISSN: 0033-8362, 1826-6983, 1826-6983electronic), 2002 Nov; 104(5-6): 421-425.
Tipo di articolo: Journal Article,
Impact factor: 1.368, Impact factor a 5 anni: 1.47
*** IBB - CNR *** Dipto. Assist. Radiol./Radioterap., Università Federico II, Napoli, Italy Ist. di Biostrutture e Bioimmagini, Consiglio Nazionale delle Ricerche, Napoli, Italy Unità Operativa di Radiologia, Università Magna Graecia, Catanzaro, Italy Via Luca da Penne, 3, 80122 Napoli NA, Italy Unit Operativa di Radiologia, Universit Magna Graecia, Catanzaro, Italy
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Reid, W., Watt, J. K., Gray, T. G., Phenol injection of the sympathetic chain (1970) Br J Surg, 57, pp. 45-50
Dondelinger, R. F., Kurdziel, J. C., Percutaneous phenol block of the upper thoracic sympathetic chain with computed tomography guidance (1987) Acta Radiologica, 28, pp. 511-515
Smithwick, H. R., Modified dorsal sympathectomy for vascular spasm (Raynaud's disease) of the upper extremity. A preliminary report (1936) Ann Surg, 104, pp. 339-342
Neumayer, C. H., Bischof, G., Fugger, R., Efficacy and safety of thoracoscopic sympathicotomy for hyperhidrosis of the upper limb. Results of 734 sympathicotomics (2001) Ann Chir Gynaecol, 90, pp. 195-199
PURPOSE: To evaluate the efficacy, safety and middle-term results of upper thoracic sympathetic chain neurolysis performed under CT guidance in patients with palmar/axillary hyperhidrosis. MATERIALS AND METHODS: From April 1999 to July 2000 we performed 30 upper thoracic sympathetic chain neurolysis in 15 patients presenting with palmar/axillary hyperhidrosis (6 M, 9 F, mean age 29.5 years). Neurolysis was performed under CT guidance injecting 2-10 ml of a solution of phenol 8%, glycerine 20% and saline through 22 G needles placed in the paraspinal space at T3 level through a paraspinal extrapleural approach. At least one week was allowed between neurolysis of right and left thoracic sympathetic chain in the same patient. Procedures were performed on outpatient basis. Patients were followed up with interviews and/or physical examination every 6 months for 2 years. RESULTS: All patients experienced immediate cessation of symptoms. Three patients (20%) experienced one-sided recurrence of symptoms 5, 7 and 12 months respectively after the first neurolysis, which disappeared after a repeated procedure. Two (13%) patients showed a slight Horner's syndrome immediately after the procedure, which resolved in 1 and 2 months respectively. Two patients (13%) experienced pain in the arm on the same side of the neurolysis, which resolved in 1 week. Three (20%) patients experienced mild compensatory sweating. All patients declared they were satisfied with the outcome of the neurolysis when interviewed at 2 years follow up from the first procedure, with no recurrence of symptoms. CONCLUSIONS: Upper thoracic sympathetic chain neurolysis performed under CT guidance in patients with palmar/axillary hyperhidrosis is a safe procedure, with low rate of complications and good results at 2 years follow-up.
331 Records (321 escludendo Abstract e Conferenze). Impact factor totale: 1030.584 (999.716 escludendo Abstract e Conferenze). Impact factor a 5 anni totale: 1163.78 (1123.23 escludendo Abstract e Conferenze).