Sympathectomy, as an emerging treatment method for cardiovascular diseases, has received extensive attention in recent years. Stereotactic radiotherapy (SRT), a precise and noninvasive therapeutic technique, has gradually been introduced into interventions targeting the sympathetic nervous system and has shown promising prospects in the management of cardiovascular conditions. Using three-dimensional imaging, SRT can accurately localize sympathetic ganglia and deliver high-energy radiation to disrupt nerve fibers, thereby achieving effects similar to conventional sympathectomy while reducing surgery-related complications and shortening recovery time. It also offers the advantages of being noninvasive and causing fewer adverse effects, and thus holds potential as an alternative to traditional approaches in the future. The integration of SRT with sympathectomy opens new avenues for the treatment of cardiovascular diseases and presents broad clinical application prospects.
Radiosurgery/methods* ; Cardiovascular Diseases/radiotherapy* ; Humans ; Imaging, Three-Dimensional ; Ganglionectomy/methods* ; Ganglia, Sympathetic/radiation effects* ; Blood Vessels/physiopathology* ; Heart/physiopathology*

Objective: To investigate the effect of bilateral superior cervical ganglionectomy on cardiac remodeling and function in pressure-overloaded heart failure (HF) mice. Methods: Pressure-overloaded HF mouse model was produced by severe thoracic aorta banding (sTAB). Bilateral superior cervical ganglionectomy (SCGx) was performed 2 weeks after sTAB. Twenty four 6-week-old male C57BL/6 mice were randomized divided into 4 groups (n=6 each): control group: sham sTAB+sham SCGx; denervated group: sham sTAB+SCGx; HF group: sTAB+sham SCGx; denervated HF group: sTAB+SCGx. Cardiac function was measured by echocardiography at week 0, 1, 2, and 4 after sTAB, respectively. All mice were sacrificed at the end of week 4 and heart tissues were harvested. HE and Masson staining were performed. Immunohistochemical staining (IHC) for tyrosine hydroxylase (TH), adrenergic receptor β1 (AR-β1) and CD68 was performed. Western blot was used to determine the protein expression level of TH, B type natriuretic peptide (BNP), and AR-β1. Results: Left ventricular ejection fraction (LVEF) declined continuously in HF group. LVEF was similar between denervated HF group and control group at various time points (P>0.05). LVEF was significantly higher in denervated HF group than in HF group at the end of week 4 (P<0.05). HE staining showed that cross sectional cardiomyocyte area was significantly larger in HF group than in control group and denervated HF group (P<0.05), which was similar between denervated HF group and control group (P>0.05). Masson staining showed that fibrosis level was significantly lower in denervated HF group than in HF group (P<0.05). IHC showed that TH+nerves and CD68⁺ macrophages were significantly increased in HF mice as compared to control mice (P<0.05), whereas this change was abolished in denervated HF group. AR-β1 was significantly down-regulated in HF group compared with control group (P<0.05), which was not affected by denervation (P>0.05). Western blot demonstrated that the expression level of TH and BNP was significantly higher in HF group compared with the control group (P<0.05), whereas this difference was diminished in denervated HF group (P>0.05). Conclusion: Bilateral superior cervical ganglionectomy can reduce sympathetic innervation and macrophage infiltration in pressure overloaded failure heart, thus attenuate cardiac remodeling and improve cardiac function.
Animals ; Cross-Sectional Studies ; Ganglionectomy ; Heart Failure ; Male ; Mice ; Mice, Inbred C57BL ; Stroke Volume ; Ventricular Function, Left ; Ventricular Remodeling

BACKGROUND: Stress, elevated sympathetic nervous system, glucocorticoid concentration affect learning and memory. The aim of this study was to evaluate the effects of superior cervical ganglionectomy on the spatial memory using radial arm maze test. METHODS: Male Sprague-Dawley rats were used. Rats were divided into two groups: a superior cervical ganglionectomy group and a control group. Each rat was put into the radial arm maze two times per day for 4 days. We checked the number of the total visit, the total error, the reference memory error, the working memory error. And then a superior cervical ganglionectomy group received bilateral superior cervical ganglionectomy, and a control group received a sham operation. The radial arm maze test was then repeated and we evaluated the effect of superior cervical ganglionectomy on spatial memory. RESULTS: There were no significant differences in ratio of total error, reference memory error, and working memory error. CONCLUSIONS: Bilateral superior cervical ganglionectomy in rats does not effect the spatial memory. However, further studies are needed to determine the effect of superior cervical ganglionectomy on spatial memory.
Animals ; Arm ; Ganglionectomy ; Humans ; Learning ; Male ; Memory ; Memory, Short-Term ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Sympathetic Nervous System

BACKGROUND: Therapeutic indications for stellate ganglion block range from head and upper arm disease to general disease including psychosomatic disorders. The aim of this study was to evaluate the effects of superior cervical ganglionectomy on anxiety using the elevated plus maze test. METHODS: Male Sprague-Dawley rats (150-250 g) were used. Each rat was put into the elevated plus maze 5 minutes per day for 10 days. We checked the number of entries into each arm (open arm and closed arm) and the duration of time staying in each arm. Rats were then divided into two groups: a group that received bilateral superior cervical ganglionectomy, and a control group that received a sham operation. The elevated plus maze test was then repeated and we evaluated the effect of superior cervical ganglionectomy on anxiety. RESULTS: Although there was an increased tendency of ganglionectomized rats to enter each arm, there were no significant differences in number of entries or in duration of stay between experimental and control groups. CONCLUSIONS: Bilateral superior cervical ganglionectomy in rats does not reduce anxiety. However, further studies are needed, ones combined with neuroendocrine and clinical studies, to determine the effect of superior cervical ganglionectomy on behavioral responses.
Animals ; Anxiety ; Arm ; Ganglionectomy ; Head ; Humans ; Male ; Psychophysiologic Disorders ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Stellate Ganglion ; Sympathectomy

BACKGROUND AND OBJECTIVES: This study was undertaken to evaluate the effect of superior cervical ganglionectomy (SCG) on anosmia, which is peripherally induced in the mice. MATERIALS AND METHOD: Three groups of mice (BCF1) were studied: normal control (nasal instillation of saline, n=6); zinc sulfate group (nasal instillation of 64 mM zinc sulfate, n=25); SCG group (superior cervical ganglionectomy after nasal instillation of 64 mM zinc sulfate, n=25). Tissues of olfactory mucosa were obtained at 1, 2, 3, 4 and 7 weeks after instillation of zinc sulfate, and processed for immunohistochemistry using antisera to olfactory marker protein (OMP) to evaluate the olfactory regeneration. RESULTS: No OMP-positive cells were observed in the first two weeks after the instillation of zinc sulfate in both zinc sulfate group and the SCG group. However, the OMP-positive cells appeared first at 3 weeks after the instillation in both groups, and gradually increased in number at 4 and 7 weeks. In the SCG group, the increase of OMP-positive cells was significantly greater than those of the zinc sulfate group. The number of OMP-positive cells in the SCG group at 7 weeks was almost similar to that of the normal control group. CONCLUSION: SCG enhances regeneration of olfactory receptor cells at 3 weeks after injury. It was inferred from the above results that SCG has a significant effect on the regeneration of olfactory receptor cells and we suggest that SCG could be an effective treatment modality for olfactory dysfunction.
Animals ; Autonomic Nerve Block ; Ganglionectomy* ; Immune Sera ; Immunohistochemistry ; Mice* ; Olfaction Disorders ; Olfactory Marker Protein ; Olfactory Mucosa ; Olfactory Receptor Neurons ; Regeneration ; Smell* ; Zinc Sulfate

BACKGROUND: C-fos is a marker of neuronal activity and its expression may be related to various types of stimulation of primary sensory neurons. We evaluated the effect of superior cervical ganglionectomy on c-fos expression in rat brain, which was expected to have the same effect as stellate ganglion block in human. METHODS: Male Sprague-Dawley rats (140-150 g) were divided into 4 groups; a no treatment (control group, n = 10), a 2 hour enflurane inhalation (anesthesia group, n = 10), a cervical skin incision only group (sham group, n = 10) and a superior cervical ganglionectomy group (sympathectomy group, n = 10). Two hours after each procedure, rats were killed and perfused with formaldehyde solution. c-fos protein expressions in the thalamus, hypothalamus, cortex, amygdala and cingulate gyrus were examined by immunohistochemistry using a specific antibody. RESULTS: In the thalamus, c-fos expression increased in the sympathectomy group vs. the control and the anesthesia groups, and in the sham group vs. the control group. In amygdala, the sham group showed significantly higher c-fos expression than the control group. In the hypothalamus and cortex no significant differences among the 4 groups were apparent. In the cingulate gyrus higher c-fos expression was observed than the control and anesthesia group but no differences with sham group. CONCLUSIONS: Superior cervical ganglionectomy itself may not affect c-fos expression in rat brain. For best results special effort should be made to avoid surgical or emotional stress.
Amygdala ; Anesthesia ; Animals ; Brain* ; Enflurane ; Formaldehyde ; Ganglionectomy* ; Gyrus Cinguli ; Humans ; Hypothalamus ; Immunohistochemistry ; Inhalation ; Male ; Neurons ; Rats* ; Rats, Sprague-Dawley ; Sensory Receptor Cells ; Skin ; Stellate Ganglion ; Stress, Psychological ; Sympathectomy ; Thalamus

Postherpetic neuralgia(PHN) is a neuropathic pain syndrome that is often intractable. A 75-year-old man suffered intractable pain due to herpes zoster between T4 and T6 dermatome. Allodynia, the severe superficial pain that he could not wear his clothes, was improved by ablative surgery such as dorsal root entry zone lesions and dorsal root ganglionectomy. However, deep cramping pain was sustained. Because of this excruciating pain, spinal cord stimulation(SCS) was decided. After the operation, the pain has been improved to tolerable state. As with our case, a constant deep cramping pain associated with other refractory painful condition of PHN, SCS could be considered as a useful option.
Aged ; Ganglionectomy ; Herpes Zoster ; Humans ; Hyperalgesia ; Muscle Cramp ; Neuralgia ; Neuralgia, Postherpetic* ; Pain, Intractable ; Spinal Cord Stimulation* ; Spinal Cord* ; Spinal Nerve Roots

We report a case of thoracic post-herpetic neuralgia which was improved by dorsal root ganglionectomy. The patient had failed to obtain adequate pain relief from conservative therapy such as carbamazepine, amitriptyline, thioridazine, gabapentin, and transcutaneous lidocaine infiltration. Thoracic dorsal root ganglionectomy from T5 to T7 on left side was performed and satisfactory pain relief without significant postoperative neurologic deficit was achieved. Although dorsal root entry zone operation for refractory pain was the most commonly performed procedure in past, dorsal root ganglionectomy is an alternative anatomically and technically safe procedure for the pain in the thoracic lesion. The clinical feature, operative technique and clinical result are presented with review of the literatures.
Amitriptyline ; Carbamazepine ; Ganglionectomy* ; Humans ; Lidocaine ; Neuralgia* ; Neurologic Manifestations ; Pain, Intractable ; Spinal Nerve Roots ; Thioridazine

Long QT syndrome is a cardiac disorder of repolarization which is characterized by elctrocardiographic abnormalities including prolonged QT interval, T-wave abnormalities and polymorphic ventricular tachycardia known as Torsades de Pointes. Its clinical manifestation are recurrent syncope, seizure, and sudden death. Recently,we experienced Torsades de Pointes(TdP) by head-up tilt test in 24 year-old female patient presenting recurrent syncope and long QT interval. Beta-blocker and left cervicothoracic sympathetic ganglionectomy were not effictive, then we tried mexiletine. After mexiletine medication, the QT interval was significantly shortened and there was no more syncope.
Death, Sudden ; Female ; Ganglionectomy ; Humans ; Long QT Syndrome* ; Mexiletine ; Seizures ; Syncope ; Tachycardia, Ventricular ; Torsades de Pointes* ; Young Adult

Long QT Syndrome is characterized by syncope and fatal ventricular arrhythmia. Monotherapy with beta blockers is the first-line therapy. In patients with recurrent syncope despite therapy with beta blockers, combinations of the following modalities of treatment may be considered: pacemakers, left cervicothoracic sympathectomy, and implantable cardioverter defibrillators. Recently, we anesthetized a patient with Long QT Syndrome who underwent thoracoscopic left upper ganglionectomy for recurrent episodes of syncope and ventricular arrhythmia despite aggressive use of propranolol. Because of the increased risk of developing fatal ventricular arrhythmias during anesthesia and surgery, we performed a left stellate ganglion block prior to induction of anesthesia to prevent the ventricular arrhythmia that may be triggered by stimulation of the sympathetic nervous system and to assess the effect of surgical ganglionectomy on the QT interval. Following the block, the QT interval was shortened, and anesthesia and surgery was uneventful though anesthetic induction caused serious sympathetic responses. We recommend a left stellate ganglion block prior to induction of anesthesia in patients with Long QT Syndrome resistant to beta blocker to prevent fatal arrhythmia and to predict the efficacy of the surgical sympathectomy on the QT interval.
Anesthesia* ; Arrhythmias, Cardiac ; Defibrillators, Implantable ; Ganglionectomy ; Humans ; Long QT Syndrome* ; Propranolol ; Stellate Ganglion* ; Sympathectomy* ; Sympathetic Nervous System ; Syncope