A Rare Case of Lateral Pectoral Nerve Injury Associated with Endoscopic Thoracic Sympathectomy for Primary Hyperhidrosis

Abstract

brachial plexus and controls the pectoralis major muscle. Isolated injury of the lateral pectoral nerve represents a rare injury to the branch of the brachial plexus [3]. According to a few reports, injury of the lateral pectoral nerve occurs due to a traction injury from trauma caused by a seat belt or sports activities [3-4]. There have been no previous reports on lateral pectoral nerve injury after endoscopic surgery for hyperhidrosis [3-4]. In this report, we present a case of lateral pectoral nerve injury after endoscopic thoracic sympathectomy with clinical symptoms of focal muscle atrophy, tingling sensation, and numbness.

Ultrasound-Guided Lateral Pectoral Nerve Pulsed Radiofrequency in a Patient With Refractory Pectoral Pain: A Case Report of a Novel Approach

“…The lateral pectoral nerve (LPN) is commonly injured along with the brachial plexus, but its isolated lesions are scarce. There are only a few reports in the literature regarding isolated LPN injury, related to sports, compression by the use of seat belts or repeated contractions of the pectoralis muscle related to training regimens, or iatrogenic to surgical procedures such as breast augmentation surgery [1][2][3].…”

“…Clinical findings of lateral pectoral nerve injury may include asymmetry of the chest wall associated with atrophy and weakness of the entire pectoralis major muscle or parts of it, and sometimes there is also pain associated. This might be explained by the fact that although this nerve mostly carries motor fiber, it is also considered to carry proprioceptive and nociceptive fibers, responsible for a part of the anterior glenohumeral joint complex innervation [ 2 - 3 ]. Plus, a partially denervated muscle or, after a while, an atrophic and weak pectoralis major muscle, when solicited, may conduct to spasms, which are described as producing intense pain.…”