Introduction

Hyperhidrosis is a dysregulation of the neural sympathetic control of the eccrine sweat glands, which leads to excessive and unpleasant sweating. The thoracic sympathetic chain is involved in the neural control of sweating in hyperhidrosis of the upper limbs. It lies in front of the neck of the thoracic ribs and under the parietal pleura. Preganglionic sympathetic fibers (white rami) synapse with ganglionic cells of the sympathetic chain, usually at the same level of the lateral horn of the spinal cord where they originate. Occasionally, these preganglionic fibers travel along the sympathetic chain downward or more commonly upward before joining a ganglionic cell at a different ...