CT-Guided Chemical Thoracic Sympathectomy versus Botulinum Toxin Type A Injection for Palmar Hyperhidrosis

Yang, Hongjun; Kang, Jianjie; Zhang, Shufen; Peng, Kairun; Deng, Bingmei

doi:10.1055/s-0038-1668599

Cited by 6 publications

(6 citation statements)

References 28 publications

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“…Over the past decades, there have been several approaches to blocking thoracic sympathetic nerve: the landmark-based approach, US-guided approach, CT-guided approach, fluoroscopically, and thoracoscopically [10][11][12][13][21][22][23] . A classic technique that does not use image guidance is a landmark-based approach that elicits a loss of resistance 21 .…”

Section: Discussionmentioning

confidence: 99%

“…Thoracic sympathetic nerve block (TSNB) can be done either in an ultrasound (US)-guided manner 12 , in a computed tomography (CT)-guided manner 13 , or thoracoscopically 10 . The US-guided and CT-guided approaches are less invasive than the thoracoscopic approach.…”

Section: Introductionmentioning

confidence: 99%

“…However, patients are hesitant to undergo thoracoscopic sympathectomy due to the possible occurrence of postoperative compensatory hyperhidrosis, which happens in 50-90% of patients, and is particularly likely in patients with craniofacial hyperhidrosis 4,5 . Since there is no effective treatment for postoperative compensatory hyperhidrosis after definite sympathectomy, many authors have proposed several strategies including limited level sympathectomy 6 , lower level sympathectomy 7,8 , sympathetic nerve clipping 9 and temporary thoracoscopic sympathetic block 10,11 .Thoracic sympathetic nerve block (TSNB) can be done either in an ultrasound (US)-guided manner 12 , in a computed tomography (CT)-guided manner 13 , or thoracoscopically 10 . The US-guided and CT-guided approaches are less invasive than the thoracoscopic approach.…”

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confidence: 99%

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Use of thoracoscopy for thoracic sympathetic nerve block in primary hyperhidrosis

Han

Ahn

Jeong

et al. 2023

Sci Rep

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Thoracic sympathetic nerve block (TSNB) has been widely used in the treatment of neuropathic pain. To reduce block failure rates, TSNB is assisted with several modalities including fluoroscopy, computed tomography, and ultrasonography. The present study describes our experience assessing the usefulness of thoracoscopy in TSNB for predicting compensatory hyperhidrosis before sympathectomy in primary hyperhidrosis. From September 2013 to October 2021, TSNB was performed under local anesthesia using a 2-mm thoracoscope in 302 patients with severe primary hyperhidrosis. Among the 302 patients, 294 were included for analysis. The target level of TSNB was T3 in almost all patients. The mean procedure time was 21 min. Following TSNB, the mean temperature of the left and right palms significantly changed from 31.5 to 35.3 °C and from 31.5 to 34.8 °C, respectively. With TSNB, primary hyperhidrosis was relieved in all patients. Pneumothorax occurred in six patients, in which no chest tube insertion was required. One patient developed hemothorax and was discharged the next day after small-bore catheter drainage. Transient ptosis developed in 10 patients and improved within a day in all patients. Our experiences showed that thoracoscopic TSNB is accurate, safe, and feasible to block the thoracic sympathetic nerve in patients with severe primary hyperhidrosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Use of thoracoscopy for thoracic sympathetic nerve block in primary hyperhidrosis

Han

Ahn

Jeong

et al. 2023

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Over the past decades, there have been several approaches to blocking thoracic sympathetic nerve: the landmark-based approach, US-guided approach, CT-guided approach, uoroscopically, and thoracoscopically (10)(11)(12)(13)(21)(22)(23). A classic technique that does not use image guidance is a landmarkbased approach that elicits a loss of resistance (21).…”

Section: Discussionmentioning

confidence: 99%

“…Thoracic sympathetic nerve block (TSNB) can be done either in an ultrasound (US)-guided manner (12), in a computed tomography (CT)-guided manner (13), or thoracoscopically (10). The US-guided and CTguided approaches are less invasive than the thoracoscopic approach.…”

Section: Introductionmentioning

confidence: 99%

Use of thoracoscopy for thoracic sympathetic nerve block in primary hyperhidrosis

Han

Ahn

Jeong

et al. 2022

Preprint

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Thoracic sympathetic nerve block (TSNB) has been widely used in the treatment of neuropathic pain. To reduce block failure rates, TSNB is assisted with several modalities including fluoroscopy, computed tomography, and ultrasonography. The present study describes our experience assessing the usefulness of thoracoscopy in TSNB for predicting compensatory hyperhidrosis before sympathectomy in primary hyperhidrosis. From September 2013 to October 2021, TSNB was performed under local anesthesia using a 2-mm thoracoscope in 302 patients with severe primary hyperhidrosis. Among the 302 patients, 294 were included for analysis. The target level of TSNB was T3 in almost all patients. The mean procedure time was 21 minutes. Following TSNB, the mean temperature of the left and right palms significantly changed from 31.5°C to 35.3°C and from 31.5°C to 34.8°C, respectively. With TSNB, primary hyperhidrosis was relieved in all patients. Pneumothorax occurred in six patients, in which no chest tube insertion was required. One patient developed hemothorax and was discharged the next day after small-bore catheter drainage. Transient ptosis developed in 10 patients and improved within a day in all patients. Our experiences showed that thoracoscopic TSNB is accurate, safe, and feasible to block the thoracic sympathetic nerve in patients with severe primary hyperhidrosis.

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Primary Hyperhidrosis

Brazzini,

Gaglani,

Sultan

2023

European Handbook of Dermatological Treatments

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CT-Guided Chemical Thoracic Sympathectomy versus Botulinum Toxin Type A Injection for Palmar Hyperhidrosis

Abstract: For palmar hyperhidrosis, thoracic sympathectomy is more effective and has a longer lasting curative effect than BTX-A injection, but thoracic sympathectomy has more complications.

Cited by 6 publications

References 28 publications

Use of thoracoscopy for thoracic sympathetic nerve block in primary hyperhidrosis

Use of thoracoscopy for thoracic sympathetic nerve block in primary hyperhidrosis

Use of thoracoscopy for thoracic sympathetic nerve block in primary hyperhidrosis

Primary Hyperhidrosis

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