Posterior Approach Endoscopic Thoracic Sympathectomy is Associated with Horner's Syndrome

For the rare patient who is not a candidate for thoracic sympathectomy (previous chest surgery, poor pulmonary function), surgeons at the University of Pittsburgh in the Department of Neurosurgery have developed a posterior approach to treat palmar hyperhidrosis.

The authors, led by Dr. Gardner have developed a minimal access endoscopic-assisted dorsal sympathectomy procedure, applying minimally invasive spine muscle splitting techniques. The authors believe that the development of this technique may help to minimize surgical morbidity associated with the traditional posterior approach by reducing pain, tissue damage, and length of postoperative recovery. This procedure was done on two patients alone.

Interestingly, one patient suffered a unilateral Horner syndrome and underwent an eyelid lift. The other patient was readmitted to the hospital 2 days after discharge with atelectasis. The researchers concluded that “this technique may provide an alternative to thoracoscopic approaches, especially in those patients with pulmonary disease or obesity”.