A surgical sympathectomy at the level of T2–T3 ganglia is performed for palmar hyperhidrosis. Which complication must be specifically anticipated from damage to the T1 ganglion?

• A Gustatory sweating (Frey's syndrome)
• B Horner's syndrome (ptosis, miosis, anhidrosis of the face) ✓
• C Loss of sweating of the entire upper limb
• D Raynaud's phenomenon due to loss of vasoconstriction

Explanation

The preganglionic sympathetic fibers for the head travel via the T1 nerve root and the inferior cervical ganglion (or stellate ganglion at C7-T1) to the superior cervical ganglion. Accidental damage to the T1 ganglion or stellate ganglion during thoracoscopic sympathectomy interrupts the oculosympathetic pathway, producing Horner's syndrome: partial ptosis (superior tarsal muscle loss), miosis (dilator pupillae loss), and facial anhidrosis (sudomotor loss). Gustatory sweating is a post-parotidectomy complication due to aberrant reinnervation of auriculotemporal nerve fibers.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.