Compensatory Hyperhidrosis and Quality of Life Post Sympathectomy for Palmar Hyperhidrosis

Ruan, Gordon; Thuppal, Sowmyanarayanan; Sawyer, Justin D.; Seadler, Benjamin; Markwell, Stephen; Hazelrigg, Stephen R.

doi:10.1177/000313481908500438

Cited by 8 publications

(4 citation statements)

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“…CH is the most common and serious side effect of ETS (9). Despite successful completion of surgery, patients experiencing postoperative CH can develop resentment and regret.…”

Section: Discussionmentioning

confidence: 99%

“…To date, patient factors, including age, gender, BMI, smoking status, and other comorbidities, have been evaluated as potential predictive factors. However, none of these were determined to be significant in predicting postoperative CH (5,9). Moreover, to date, there have been many studies that assessed the level of ETS (R2, R3, and R4) and multi-level sympathectomy as possible risk factors for postoperative CH (17,18).…”

Section: Discussionmentioning

confidence: 99%

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To avoid compensatory hyperhidrosis after sympathetic surgery for craniofacial hyperhidrosis

et al. 2020

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Background: Endoscopic thoracic sympathectomy (ETS) has not been widely adopted for treating craniofacial hyperhidrosis (CFH) due to its known postoperative complication, compensatory hyperhidrosis (CH). In this study, we evaluated whether the autonomic nerve analysis data via pre-ETS heart rate variability (HRV) test can predict post-ETS CH in patients with CFH.Methods: From October 2017 to March 2019, we consecutively included CFH patients who underwent ETS and received preoperative HRV. In this prospective observational study, we evaluated those who developed CH 3 months postoperatively. The CH grades were categorized into none, mild, moderate, and severe.Results: A total of 53 patients were included; the mean age was 42.5±13.2 years, and there were 41 males (77.4%). Twenty-six (49.1%) patients had a post-ETS CH grade of greater than moderate (moderate and severe). We further classified the group into trivial and serious compensation, based on the CH grade for comparison. Among the various HRV values, low frequency/high frequency (LF/HF) value was the only one that achieved statistical significance (P=0.025). Moreover, among those in the trivial compensatory group, 23 (85.2%) patients had an LF/HF value between 0.66 and 2.60, and therefore, were included in the autonomic balanced group. On the other hand, among those in the serious compensatory group, 24 patients (92.3%) had an LF/HF value of less than 0.66 and greater than 2.60, and thus, in the autonomic dysfunction group.Conclusions: According to the present study, HRV test, especially the HF/LF value, appears to be a useful test in predicting post-ETS serious CH.

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“…CH is the most common and serious side effect of ETS (9). Despite successful completion of surgery, patients experiencing postoperative CH can develop resentment and regret.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

To avoid compensatory hyperhidrosis after sympathetic surgery for craniofacial hyperhidrosis

et al. 2020

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“…Just after the TS patients are pleased as they do not longer sweat in the areas where it was incredibly cumbersome (hands and axillae) [9], but as time goes by, especially during the summer, they notice sweating in areas that did not sweat before or not to such an extent, such as the abdomen, torso, buttocks, and thighs [10]. This new sweating is known as compensatory hyperhidrosis (CH) and is the fundamental cause of long-term patients' dissatisfaction [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Selective T3-T4 Sympathicotomy Versus Gray Ramicotomy On Outcome And Quality Of Life In Hyperhidrosis Patients. A Randomized Clinical Trial.

Vanaclocha

Guijarro-Jorge

Saiz-Sapena

et al. 2021

Preprint

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Background: compensatory hyperhidrosis is the leading cause of patients' dissatisfaction after thoracic sympathicotomy.Objective: to reduce compensatory hyperhidrosis to increase patients' satisfaction. Patients and methods: a prospective randomized study on palmar hyperhidrosis, May 2016-September, 2019. Twenty-one patients T3-T4 sympathicotomy and 21 T3-T4 gray ramicotomy. Data prospectively collected. Analysis at study's end. Focus on the sweating, temperature, quality of life baseline and postoperatively, compensatory hyperhidrosis, hand dryness, patients' satisfaction, and if they would undergo the procedure again and would recommend it.Results: No baseline differences between groups. Hyperhidrosis was controlled postoperatively in all patients. No mortality, serious complications, or recurrences. Sympathicotomy worse postoperative quality of life (49.05 (SD: 15.66, IR: 35.50-63.00) versus ramicotomy 24.30 (SD: 6.02, IR: 19.75-27.25). After ramicotomy, some residual sweating on the face, hands, and axillae. Compensatory sweating worse with sympathicotomy. Satisfaction higher with ramicotomy. Better results with ramicotomy than sympathicotomy regarding hand dryness, how many times a day the patients had to shower or change clothes, intention to undergo the procedure again or recommend it to somebody else, and how bothersome compensatory hyperhidrosis was.Conclusions: T3-T4 gray ramicotomy had better results than T3-T4 sympathicotomy, with less compensatory sweating and higher patients' satisfaction.

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“…Many methods for diagnosing hyperhidrosis are currently available. The Hyperhidrosis Disease Severity Scale (HDSS) 6 is designed to subjectively evaluate the impact of sweating on everyday life. The scale has 4 grades, with Grade 1 indicating that the sweating is never noticeable and never interferes with daily activities, whereas Grade 4 indicates that the sweating is intolerable and always interferes with daily activities.…”

Section: Introductionmentioning

confidence: 99%

Moisture Response Films Versus the Starch Iodine Test for the Detection of Palmar Hyperhidrosis

Shehadeh

Bar‐Ilan

Mehrabi

et al. 2021

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BACKGROUND The starch iodine test (SIT) is the gold-standard diagnostic tool for primary palmar hyperhidrosis (PPH). OBJECTIVE This study aimed to evaluate the clinical effectiveness and safety profile of a novel approach for the detection of PPH by moisture response films (MRF) in comparison to the SIT. METHODS This prospective comparative study of the 2 tests was conducted on 17 patients with PPH. Disease severity was evaluated by the SIT and the MRF methods during 4 sessions (twice before and twice after botulinum toxin [BTX] injections) on different days and by different investigators. The physician's global assessment (PGA) scoring of the comparable visual results was evaluated by 2 blinded independent dermatologists. The Hyperhidrosis Disease Severity Scale (HDSS) scores of the patients at baseline and after the BTX injections were correlated with the SIT and MRF results. RESULTS The objective PGA scoring of the SIT results demonstrated poor correlation, whereas the objective PGA scoring of the MRF results correlated highly with the patients' HDSS scores both at baseline and after the BTX injections. CONCLUSION Analysis of palmar hyperhidrosis by means of MRF was superior to SIT and was demonstrated to be more efficient, convenient, and accurate.

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Compensatory Hyperhidrosis and Quality of Life Post Sympathectomy for Palmar Hyperhidrosis

Cited by 8 publications

References 4 publications

To avoid compensatory hyperhidrosis after sympathetic surgery for craniofacial hyperhidrosis

To avoid compensatory hyperhidrosis after sympathetic surgery for craniofacial hyperhidrosis

Selective T3-T4 Sympathicotomy Versus Gray Ramicotomy On Outcome And Quality Of Life In Hyperhidrosis Patients. A Randomized Clinical Trial.

Moisture Response Films Versus the Starch Iodine Test for the Detection of Palmar Hyperhidrosis

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