Can Honnath's Phenomenon Be Prevented in Sympathetic Nerve Surgery?

Q: Can Honnath's Phenomenon Be Prevented in Sympathetic Nerve Surgery?

Hello： Essentially, this is a relatively new technology, and most physicians do not have much experience with it. <br>However, any surgery may have potential complications, so it is important to discuss thoroughly with your physician before making a decision. <br>Sincerely, Dr. <

Can the symptoms of hyperhidrosis be anticipated and avoided in advance?

I would like to ask a physician in the southern region who believes that using a titanium clip to block the superior margin of the second nerve can treat my facial flushing and mild erythema.
He thinks this is an issue of sympathetic nerve hyperactivity.
After undergoing his surgery two years ago, I experienced significant Horner's syndrome, including redness in my eyes and ptosis of my right eyelid, along with severe nasal congestion due to swelling inside my nose.
After the titanium clip was removed, my symptoms gradually improved over six months.
However, recently, according to that physician, the recurrence of facial flushing may be related to nerve regeneration.
He informed me that the last time, the clip was placed closer to the first ganglion, which caused the Horner's syndrome.
If I wish to undergo the procedure again, he suggested lowering the placement by about one rib distance while still targeting the superior margin of the second nerve, assuring me that I would not experience such side effects again and that it would definitely resolve my flushing issue.
Therefore, I have some doubts:
1.
Can simply lowering the placement by a little really guarantee the avoidance of Horner's syndrome, or could it still occur anywhere along the second nerve, given the previous experience?
2.
Is this treatment for facial flushing (which he refers to as rosacea on his website) currently only being performed by him? Is this within the realm of dermatology or sympathetic nerve surgery?
3.
After having undergone two surgeries (implantation and removal), is it still possible for me to have a third surgery?
4.
Should I believe this assurance that there will be no sequelae? Aside from discomfort compensation, I would greatly appreciate Dr.
Ding's detailed answers.
Thank you very much.

A-Feng, 20~29 year old female. Ask Date: 2006/02/28

Dr. Ding Xianwei reply Neurosurgery

Hello: Essentially, this is a relatively new technology, and most physicians do not have much experience with it.
However, any surgery may have potential complications, so it is important to discuss thoroughly with your physician before making a decision.
Sincerely, Dr.
Ding Hsien-Wei, Neurosurgery.

Reply Date: 2006/02/28

More Info

Honnath's phenomenon, also known as compensatory sweating or gustatory sweating, is a condition that can occur after sympathetic nerve surgery, particularly when the sympathetic chain is interrupted. This phenomenon can lead to unexpected sweating in areas not typically affected, often as a compensatory mechanism due to the loss of sympathetic innervation in the original area.
1. Can Honnath's Phenomenon Be Prevented?
Preventing Honnath's phenomenon entirely is challenging. The risk of developing this phenomenon is associated with the surgical technique and the specific nerves involved. The suggestion to adjust the placement of the titanium clip to a lower position on the second sympathetic nerve may reduce the risk, but it does not guarantee prevention. The anatomy of the sympathetic nervous system is complex, and variations in individual anatomy can lead to different outcomes. Thus, while a lower placement may theoretically reduce the risk of Honnath's phenomenon, it is not a foolproof solution.
2. Is the Treatment for Facial Flushing Unique to One Surgeon?
The treatment for facial flushing, particularly when linked to sympathetic nerve dysfunction, is not exclusive to one surgeon or technique. Various methods exist, including surgical interventions, pharmacological treatments, and non-invasive options. The approach taken often depends on the underlying cause of the symptoms and the patient's specific condition. The term "rosacea" used by the surgeon may refer to a skin condition characterized by facial redness, which can be exacerbated by sympathetic nervous system activity. This falls under the purview of dermatology, but the surgical intervention to address sympathetic nerve issues is typically managed by a surgeon specializing in neurosurgery or vascular surgery.

3. Can You Undergo a Third Surgery?
Undergoing a third surgery is possible, but it should be approached with caution. Each surgical intervention carries risks, including the potential for complications or the exacerbation of existing symptoms. A thorough evaluation by a qualified surgeon, including a review of your medical history, previous surgeries, and current symptoms, is essential before proceeding. It is crucial to weigh the potential benefits against the risks involved in additional surgery.

4. Can You Trust the Assurance of No Side Effects?
While it is common for surgeons to provide assurances regarding the risks of surgery, it is important to understand that no surgical procedure is without risk. The potential for side effects, including Honnath's phenomenon, should be discussed openly with your surgeon. It is advisable to seek a second opinion, especially if you have concerns about the likelihood of complications or if previous surgeries have not yielded the desired results. Understanding the full scope of potential outcomes, including both positive and negative effects, will help you make an informed decision about your treatment options.

In conclusion, while there are strategies to potentially reduce the risk of Honnath's phenomenon during sympathetic nerve surgery, complete prevention is not guaranteed. The treatment for facial flushing is multifaceted and not limited to one surgical approach. If considering further surgery, it is vital to have a comprehensive discussion with your healthcare provider about the risks, benefits, and realistic expectations. Always feel empowered to seek multiple opinions to ensure that you are making the best decision for your health.

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