Can Thoracic Sympathetic Nerve Damage Be Reversed?

Abstract

Background: Function of the thoracic sympathetic chain (TSC) reportedly recovers after surgical clips are removed. Hence, this study was designed to study nerve regeneration after unclipping the TSC.

Methods: The bilateral TSCs of six goats were studied; the goats were separated into three groups (groups I, II, and III) during excision, clipping, and unclipping. During surgery, the TSCs were excised with a scalpel in group I and clipped in groups II and III. In group III, the clips were removed 1 month postoperatively and observed for possible nerve healing for 1 month. All TSCs were examined histologically following en block resection at 1 month postoperatively in groups I and II and at 2 months postoperatively in group III.

Results: Inflammation in nerve sections was noted following clip removal. Furthermore, there was significant degeneration and cell infiltration in the nerve fibers of the clipped regions. The Schwann cells around the peripheral nerve endings in the unclipped regions facilitated nerve transmission by reconstitution of myelin.

Conclusion: Clipping the TSC can cause histologic degeneration; however, histologic nerve regeneration occurs after unclipping.