الفهرس 
Introduction
CausalgiaOnly 14 pages are availabe for public view
 |  | from | 236 |  |  |
| | | from | 236 | | |
Abstract
Although surgery of the sympathetic nervous system represents a small part of the practice of current neurosurgery, ablation of the upper thoracic sympathetic trunk has proved most successful in the management of the upper limb hyperhidrosis, causalgia, reflex sympathetic dystrophy and Raynaud?s phenomenon. Because of the inaccessibility of the sympathetic chain, however, a variety of surgical approaches have been advised. Each has been complicated by restricted access and relatively high complication rates. Endoscopic transthoracic techniques of ablation of the sympathetic trunk have the advantage of a minimally invasive approach with excellent visualization of the sympathetic trunk and rapid postoperative recovery. This change in surgical approach has been facilitated by the rapid advances in instrument technology, particularly the improvement in optical systems allowing the use of high quality video endoscopes. A variety of pain disorders involving the upper extremities (e.g.:causalgia) can be managed with sympathetic denervation. Causalgia is a painful condition that can occur after a partial injury to a mixed peripheral nerve. Complete and permanent sympathetic denervation of the upper extremity can be achieved by removal of the second thoracic ganglion alone. The operation is safe, costeffective, well tolerated and leads to a high level of patient satisfaction. This is added to the advantage of the superior cosmetic result that is achieved through short incisions in the axilla.