View Associated Notes
Category 3 - THERAPEUTIC PROCEDURES
35003 - Additional Information
CERVICAL OR UPPER THORACIC SYMPATHECTOMY by any surgical approach
(Anaes.) (Assist.)
Fee: $1,070.20 Benefit: 75% = $802.65
(See para TN.8.295 of explanatory notes to this Category)
Associated Notes
Category 3 - THERAPEUTIC PROCEDURES
TN.8.295
Endoscopic Thoracic Sympathectomy
Appropriate Use Guidance
Hyperhidrosis
Sympathectomy can be a valuable treatment for a limited number of patients with hyperhidrosis who have tried and failed to respond to non-surgical intervention. Non-surgical options include but are not limited to:
- Topical aluminium chloride hexahydrate or aluminium chloral hydrate (antiperspirants)
- Botulinum toxin A injection of the sweat glands
- Iontophoresis
- Topical anticholinergic creams, gels and sprays, or prescription underarm wipes
- Oral anticholinergics for e.g. propantheline bromide, glycopyrrolate, oxybutynin, and methantheline bromide
- Laser therapy to the affected area
- Microwave therapy to the affected area
It would be expected that a patient with treatment resistant hyperhidrosis would be under the care of a Dermatologist and the decision to undertake surgical sympathectomy would involve the patient’s general practitioner, dermatologist and the treating surgeon.
Refractory Cardiac Arrhythmias
Sympathectomy may be performed on patients as an adjunct to lifelong optimal medical therapy for refractory cardiac arrhythmias including, but not limited to:
- Congenital long QT syndrome
- Extreme non-congenital prolonged QT syndrome
- Catecholaminergic polymorphic ventricular tachycardia (CPVT)
Vascular Indications
Sympathectomy may be performed on patients as an adjunct to lifelong optimal medical therapy for the management of treatment resistant (but not limited to):
- small vessel vasospastic pathology related to:
- Raynaud’s disease
- Scleroderma
- Acrocyanosis
- Livedo reticularis
- Upper limb ischaemia pain (e.g. thromboangiitis obliterans)
- Chronic regional pain syndrome
Legend
- Assist - Addition/Deletion of (Assist.)
- Amend - Amended Description
- Anaes - Anaesthetic Values Amended
- Emsn - EMSN Change
- Fee - Fee Amended
- Renum - Item Number Change (renumbered)
- New - New Item
- NewMin - New Item (previous Ministerial Determination)
- Qfe - QFE Change