Thoracic sympathectomy for palmar hyperhidrosis: report of 457 cases.

A thoracic sympathetic ganglionectomy was performed on 457 patients with palmar hyperhidrosis, resulting in a complete cessation of the excessive palmar sweating but not a total abolition of the sweating of the upper extremity, forehead, face, neck, upper chest and upper back. This procedure does not produce a Horner's syndrome. The present data provide evidence that sympathetic pathways for controlling sweating of the above-mentioned skin areas come mainly through the second thoracic ganglion, and therefore from the spinal cord segment below T1 in man.