Compensatory sweating was originally
thought to be a mechanism of excessive sweating (in an anatomical
region with an intact sympathetic nervous system) to maintain
a constant rate of total sweat secretion.90 However, this theory was
not confirmed by other studies, demonstrating that compensatory
sweating represented a reflex action by an altered feedback mechanism
at the level of the hypothalamus which is dependent on the
level at which sympathetic denervation occurs. Sympathectomy at
the level of the T2 ganglion leads to decreased negative feedback
to the hypothalamus. When performing a sympathectomy at a
lower level, the negative feedback to the hypothalamus is less
inhibited, leading to a decrease in compensatory sweating. Chou
et al.91 have proposed the term ‘reflex sweating’ to replace compensatory
sweating. Other side effects described in a review article
by Dumont89 are gustatory sweating, cardiac effects, phantom
sweating, lung function changes, dry hands and altered taste.
Besides these side effects there are significant risks of complications
during and after surgery (arterial or venous vascular injury, pneumothorax,
infection, Horner syndrome etc.).
JEADV 2012, 26, 1–8 Journal of the European Academy of Dermatology and Venereology
