Comparative analysis of T2 selective division of rami-communicantes (ramicotomy) with T2 sympathetic clipping in the treatment of craniofacial hyperhidrosis☆

Kim, Do-Hyung; Paik, Hyo Chae; Lee, Deuk Yong

doi:10.1016/j.ejcts.2004.04.030

Cited by 33 publications

(26 citation statements)

References 20 publications

(16 reference statements)

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“…2 Video-assisted thoracic sympathectomy (VATS) provides excellent resolution of facial hyperhidrosis, but is associated with certain complications, especially with compensatory hyperhidrosis, which is the most frequent and important complication. [3][4][5][6] This occurs, to a mild degree, in most patients who have undergone the treatment of palmar or axillary hyperhidrosis. However, the risk is particularly higher in patients treated for FH who have been submitted to the resection of the second thoracic ganglion, which may cause dissatisfaction with the procedure.…”

Section: Introductionmentioning

confidence: 99%

The use of oxybutynin for treating facial hyperhidrosis

Wolosker

Campos

Kauffman

et al. 2011

An. Bras. Dermatol.

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BACKGROUND: Facial hyperhidrosis is a disease that may lead patients to serious emotional disturbances. Video-assisted thoracic sympathectomy provides excellent resolution of facial hyperhidrosis, but is associated with certain complications. The most frequent and important complication is compensatory hyperhidrosis. Especially in patients who have undergone resection of the second thoracic ganglion, the risk of severe compensatory hyperhidrosis is higher, which may cause dissatisfaction with the procedure. OBJECTIVE: The aim of this study was to evaluate the efficacy of the use of low doses of oxybutynin in treating facial hyperhidrosis as well as the level of patient satisfaction with its use. METHODS: 25 patients with facial hyperhidrosis were treated with oxybutynin. The patients underwent 2 evaluations: before and after treatment. These evaluations were used to assess the patients' clinical improvement and quality of life. RESULTS: We observed that more than 75% of the patients evolved with an improvement in facial hyperhidrosis, and 52% of them presented a great improvement. CONCLUSION: Treatment of facial hyperhidrosis with oxybutynin is a good alternative to sympathectomy, since it presents good results and improves quality of life, in addition to not exposing patients to the risk of experiencing the side effects of sympathectomy. Keywords: Advanced treatment; Clinical protocols; Hyperhidrosis; Indicators of quality of life; Sympathectomy; Sweating Resumo: FUNDAMENTOS: Hiperidrose facial é uma doença que pode levar os pacientes a sérios distúrbios emocionais. A simpatectomia torácica vídeo-assistida proporciona excelente resolução da hiperidrose facial, mas está associada a algumas complicações, sendo a mais freqüente e mais importante a hiperidrose compensatória. Especialmente em pacientes submetidos à ressecção do segundo gânglio torácico, o risco de hiperidrose compensatória grave é maior, o que pode causar insatisfação com o procedimento. OBJETIVO: O objetivo deste estudo foi avaliar a eficácia e a satisfação dos pacientes com o uso da oxibutinina em doses baixas para tratar a hiperidrose facial em uma série grande de pacientes. MÉTODOS: 25 pacientes com hiperidrose facial foram tratados com oxibutinina. Os pacientes foram submetidos a duas avaliações: antes e depois do tratamento. Estas foram usadas para avaliar a melhoria clínica e a qualidade de vida. RESULTADOS: Observou-se que mais de 75% dos pacientes evoluíram com melhora na hiperidrose facial, sendo que 52% deles apresentaram uma grande melhora. CONCLUSÃO: O tratamento da hiperidrose facial com oxibutinina é uma boa alternativa à simpatectomia, visto que apresenta bons resultados e melhora a qualidade de vida, e os pacientes não correm o risco dos efeitos colaterais da simpatectomia.

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Section: Introductionmentioning

confidence: 99%

The use of oxybutynin for treating facial hyperhidrosis

Wolosker

Campos

Kauffman

et al. 2011

An. Bras. Dermatol.

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“…Drawbacks to thoracoscopic ramicotomy are a longer operating time and an increased possibility of accidental injury to the intercostal vessels [11]. Therefore, ramicotomy is not easily accomplished by conventional thoracoscopy [9,10,11,12]. Ramicotomy is a more selective and physiological treatment of essential hyperhidrosis than sympathectomy or sympathicotomy.…”

Section: Discussionmentioning

confidence: 99%

“…Ramicotomy shows the lowest rate of compensatory hyperhidrosis and the lowest rate of Horner's syndrome [8]. However, a selective thoracic ramicotomy is not easily accomplished by conventional thoracoscopy and questions have been raised concerning the effectiveness of this technique [9,10,11,12]. The DaVinci® three-dimensional optical imaging system enhances visualization and the endowrist technology promotes telemanipulation of soft tissue structures in a relatively inaccessible working space.…”

Section: Introductionmentioning

confidence: 99%

Robot-Assisted Ramicotomy: Evaluation in a Swine Model

Coveliers

Hoexum²,

Yeung³

et al. 2013

Eur Surg Res

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Background: To evaluate the feasibility of robot-assisted thoracoscopic T2-T5 ramicotomy. Methods: In 5 pigs, a robot-assisted thoracoscopic T2-T5 ramicotomy was performed, followed by T2-T5 sympathectomy 10 min later. Ramicotomy and sympathectomy times, and core (esophageal) and surface (left front foot) temperatures, were monitored and recorded. Results: The procedure was successfully completed in all 5 animals. In all cases, the sympathetic chain remained intact. No major hemorrhage occurred. The mean operating time for T2-T5 ramicotomy from incision until transsection of the last efferent ramus was 34 min (32-40). After completion of the ramicotomy, a total T2-T5 sympathectomy was performed, with a mean duration of 7 min (4-12). Mean core temperature before the operation was 37.6°C (36.7-38.0). Mean surface temperature before the operation was 34.2°C (33.3-35.5). Ten minutes after completion of the ramicotomy, temperatures stabilized. Mean postramicotomy core temperature was 37.4°C (36.3-38) and mean postramicotomy surface temperature was 35.4°C (33.9-37). Mean postsympathectomy temperatures were: core 37.3°C (36.1-38) and surface 35.8°C (33.8-37.1). Conclusion: Robot-assisted thoracoscopic T2-T5 ramicotomy is feasible and effective in a porcine model.

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“…A lower T1-T3 [4]), a T2 [5][6][7][8]), a T2-T3 [8,9]) or a T3-T4 [9]) sympathicotomy have been used for blushing. Level T2 and level T2-T3 are equally effective [8]) , but compensatory sweating was significantly more frequent in the group treated with T2-T3 sympathicotomy.…”

Section: Blushing and Facial Hyperhidrosismentioning

confidence: 99%