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Related Experiment Videos

Thoracoscopic sympathicolysis for essential hyperhidrosis: effects on pulmonary function

M Noppen1, W Vincken

  • 1Respiratory Division, Academic Hospital, AZ-VUB, University of Brussels, Belgium.

The European Respiratory Journal
|August 1, 1996
PubMed
Summary

Thoracoscopic sympathicolysis for hyperhidrosis causes temporary, minimal lung function changes. Permanent effects are minor, suggesting sympathetic nerves influence airway tone in these patients.

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Area of Science:

  • Pulmonary Medicine
  • Thoracic Surgery
  • Neurosurgery

Background:

  • Bilateral upper dorsal sympathetic chain interruption at D2-D3 is the sole permanent cure for essential hyperhidrosis.
  • Surgical sympathectomy can cause significant pulmonary function changes.
  • The impact of thoracoscopic sympathicolysis on pulmonary function needs evaluation.

Purpose of the Study:

  • To assess pulmonary function changes after thoracoscopic sympathicolysis for essential hyperhidrosis.
  • To differentiate effects of denervation from the thoracoscopy procedure itself.
  • To investigate the influence of sympathetic innervation on airway bronchomotor tone.

Main Methods:

  • Pulmonary function tests (spirometry, body plethysmography) were performed before and 6 weeks after thoracoscopic sympathicolysis in 47 patients.

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  • Pulmonary function tests were repeated at 6 months in 35 patients to isolate procedure effects.
  • Analysis included spirometry, lung volumes, airway resistance, and conductance.

    • Main Results:

    • Essential hyperhidrosis was resolved in all patients.
    • No respiratory symptoms were reported post-procedure.
    • Minor, temporary reductions in FEV1, FEF75, and TLC were observed at 6 weeks, with increased airway resistance.
    • At 6 months, TLC normalized, but FEF75 remained decreased, with persistent changes in FEV1/FVC and Raw.

    Conclusions:

    • Thoracoscopic sympathicolysis causes minimal, subclinical pulmonary function changes, primarily due to temporary lung volume reduction from the procedure.
    • D2-D3 sympathicolysis results in a small, permanent decrease in forced expiratory flow.
    • Sympathetic innervation appears to influence airway bronchomotor tone in essential hyperhidrosis patients.