Friday, November 20, 2009

Hyperhidrosis surgery?

Can somone with experience(someone who has gone through it) or any nowledge of the T1 T2 T3 and T4 please explain to me what places of the body they refer to. In other words, what are the difference in the T1-T4. Thanks, would really help me alot.

Hyperhidrosis surgery?
Preganglionic fibers from the spinal cord synapse in sympathetic ganglia at the segment from which they arise travel up or down the sympathetic chain to synapses in other ganglia. Postganglionic fibers join peripheral nerves to innervate the sweat glands. The sympathetic outflow to the arm originates from the T2 to T6 ganglia, and for some patients T1 fibers (from the stellate ganglion, a fusion of T1 and C8) also innervate the arms. Fibers to the face come primarily from the stellate ganglia (C8 and T1), with some contribution from T2 and T3. Resection of the stellate ganglion is more likely to cause Horner’s syndrome than resection of T2 and T3 ganglia. In addition, there is an anatomical variation—the nerve of Kuntz—seen in 10% of patients. It arises from the T2 and T3 spinal segments and bypasses the cervical chain to join the brachial plexus. The feet are innervated by L2 to L4. To affect palmar sweating, T2 and sometimes T3 ganglia must be ablated, and for axillary sweating, at least T3 and sometimes T4 and T5. For plantar sweating, the L2 to L4 ganglia should be ablated, but, because sexual side effects can occur with ablation at this level, sympathectomy for plantar symptoms is rarely done. For facial hyperhidrosis, ablation of T2 and T3 can decrease sweating, as can sympathectomy of the lower third of the stellate ganglion.


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