The results are usually immediate and a surprise to the patient who finds him/herself dry and warm for the first time in many years. The procedure is almost always successful. If the patient has reported plantar (foot) hyperhidrosis, in two out of three cases this is resolved by the surgery also. Patients report that they feel less anxious in stressful situations. Stage fright is reduced. The results are usually permanent.
Friday, November 20, 2015
Snipping the nerve may stop 'flight-or-fight' stress response
What do sweaty palms and abnormal heart rhythms have in common? Both can be initiated by the nervous system during an adrenaline-driven "flight-or-fight" stress reaction, when the body senses danger.
Hyperhidrosis, an abnormal flight-or-fight response of the sympathetic nervous system that causes excessively sweaty palms may also contribute to problems like dangerous irregular rhythms from the lower chambers of the heart, known as ventricular arrhythmias.
UCLA cardiologists have now found that surgery to snip nerves associated with the sympathetic nervous system on both the left and right sides of the chest may be helpful in stopping dangerous, incessant ventricular arrhythmias — known as an "electrical storm" — when other treatment methods have failed. This same type of surgery has been used for years to alleviate hyperhidrosis.
The UCLA team's findings are reported in the Dec. 27–Jan. 3 issue of the Journal of the American College of Cardiology. The study is one of the first to assess the impact of bilateral cardiac sympathetic denervation (BCSD), surgery on both sides of the heart, to control arrhythmias. The research builds on previous work at UCLA in which a similar procedure was performed only on the left side. But for some patients to obtain relief, the researchers said, it must be done bilaterally.
Hyperhidrosis, an abnormal flight-or-fight response of the sympathetic nervous system that causes excessively sweaty palms may also contribute to problems like dangerous irregular rhythms from the lower chambers of the heart, known as ventricular arrhythmias.
UCLA cardiologists have now found that surgery to snip nerves associated with the sympathetic nervous system on both the left and right sides of the chest may be helpful in stopping dangerous, incessant ventricular arrhythmias — known as an "electrical storm" — when other treatment methods have failed. This same type of surgery has been used for years to alleviate hyperhidrosis.
The UCLA team's findings are reported in the Dec. 27–Jan. 3 issue of the Journal of the American College of Cardiology. The study is one of the first to assess the impact of bilateral cardiac sympathetic denervation (BCSD), surgery on both sides of the heart, to control arrhythmias. The research builds on previous work at UCLA in which a similar procedure was performed only on the left side. But for some patients to obtain relief, the researchers said, it must be done bilaterally.
Wednesday, November 4, 2015
The implications of these responses on thermoregulation remain unknown
Prior to the heat stress, skin blood flow was not different between pre/ post-surgery trials (122 ± 13 versus 120 ± 17 units; P = 0.95). However the magnitude of the increase in skin blood flow to whole- body heating was attenuated after the surgical procedure (pre- surgery: 299 ± 35 units to post-surgery: 132 ± 31 units; P b 0.01). Similarly, the increase in sweat rate to the heat stress was attenuated after sympathectomy (pre-surgery: 0.62 ± 0.1 mg/cm2/min to post- surgery: 0.28 ± 0.01 mg/cm2/min; P = 0.046). Conclusion: These data indicate that the increase in forearm skin blood flow and sweat rate to a whole-body heat stress are attenuated by ~50% after surgical sympathectomy. The implications of these responses on thermoregulation remain unknown.
Endoscopic sympathectomy impairs forearm cutaneous vasodilation and sweating during passive heat stress
Autonomic Neuroscience: Basic and Clinical 192 (2015) 56–141
http://www.isan2015.org/media/Poster_abstracts.pdf
C.G. Crandalla, D.M. Meyerb, S.L. DaviscaDepartment of Internal Medicine, University of Texas Southwestern Medical Center and TX Health Presbyterian Hospital Dallas USA bDepartment of Cardiothoracic Surgery, University of TX Southwestern Medical Center Dallas USAcDepartment of Applied Physiology & Wellness, Southern Methodist University, Dallas USA
Autonomic Neuroscience: Basic and Clinical 192 (2015) 56–141
http://www.isan2015.org/media/Poster_abstracts.pdf
C.G. Crandalla, D.M. Meyerb, S.L. DaviscaDepartment of Internal Medicine, University of Texas Southwestern Medical Center and TX Health Presbyterian Hospital Dallas USA bDepartment of Cardiothoracic Surgery, University of TX Southwestern Medical Center Dallas USAcDepartment of Applied Physiology & Wellness, Southern Methodist University, Dallas USA
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