Extensive or partial microsurgical sympathectomy of the arm by supraclavicular route for primary or secondary Raynaud symptoms.
Surgery was performed in patients with Raynaud's disease (primary Raynaud symptoms) or with Raynaud symptoms as part of the cervical rib/scalenus-anticus syndrome (secondary Raynaud symptoms). In 13 arms with primary, and six with secondary Raynaud symptoms with trophic changes, the aim was extensive sympathectomy. Good results, without Horner's syndrome, were obtained with extensive postganglionic sympathectomy. When the grey ramus T1 could not be identified, T2 ganglionectomy and extirpation of the grey rami C7 and C8 were performed with the same result. Extirpation of the grey ramus C6 was not mandatory for a good result. Extirpation of unidentified T1 rami resulted in permanent Horner's syndrome in two of four patients. Cases of secondary Raynaud symptoms without trophic changes were divided into two equal groups, each of 18 arms. Combined neurovascular decompression and partial sympathectomy were performed in one group, and neurovascular decompression only in the other. Partial sympathectomy seemed to improve the results.
Magnaes
B
B
Department of Neurosurgery, Ullevål Hospital, Oslo University Hospital, Norway.
D000328:Adult; D001132:Arm; D005260:Female; D005500:Follow-Up Studies; D006732:Horner Syndrome / Q000209:etiology; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D011859:Radiography; D011928:Raynaud Disease / Q000628:therapy*; D013348:Subclavian Artery / Q000000981:diagnostic imaging; D013562:Sympathectomy / Q000009:adverse effects / Q000379:methods*