Needlescopic thoracic sympathetic block by clipping for craniofacial hyperhidrosis

Lin, Tzu-Chen; Chou, Ming-Chih

doi:10.1007/s00464-001-8231-6

Cited by 23 publications

(12 citation statements)

References 8 publications

(32 reference statements)

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“…In contrast to our findings, a percentage of CS between 67 % and 77 % has been described in cases of "non-limited" sympathectomy for FB [5,24,30]. For FH 80 % of CS has been reported after ablation of the lower part of the stellate ganglion [18] and 85.7 % after clipping the lower third of the stellate ganglion [17].…”

Section: Discussioncontrasting

confidence: 84%

Experience with limited endoscopic thoracic sympathetic block for hyperhidrosis and facial blushing

Neumayer

Zacherl

Holak

et al. 2003

Clinical Autonomic Research

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Endoscopic thoracic sympathetic block (ESB) has recently become a popular modification of sympathetic surgery, as it offers the potential chance of reversibility. In order to reduce side effects such as compensatory sweating limited ESB at the levels of the T2, T3 or T4 ganglia has been recommended (Lin/Telaranta classification). We present our experience and initial results with this technique. From 6/2001 to 2/2003, 184 ESB procedures were performed in 94 patients. ESB4 was carried out in 53 patients for hyperhidrosis (HH) of the upper limb. In 23 patients ESB3 was performed for craniofacial HH and 18 patients suffering from facial blushing were treated by ESB2. Median follow-up was 5.2-7.5 months.Success rates were similar (~100%) in all groups. Compensatory sweating was found in 25% in the ESB3 compared to 12.5 % in the ESB2 and 8.5 % in the ESB4 group (p < 0.05). Gustatory sweating did not differ significantly between the groups (6.3 % in ESB2, 5% in ESB3 and 2.1 % in ESB4 group). Five patients were reoperated in the ESB3 group (3 because of a side-difference of the effect in the face, 1 patient due to incomplete Horner's syndrome and 1 due to massive compensatory sweating). In the ESB4 group all patients were satisfied with the outcome, whereas in the ESB2 group 6.3% and in the ESB3 group 13.9% were partly satisfied. Limited sympathetic surgery offers comparably high success and satisfaction rates along with a low rate of side effects.

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Section: Discussioncontrasting

confidence: 84%

Experience with limited endoscopic thoracic sympathetic block for hyperhidrosis and facial blushing

Neumayer

Zacherl

Holak

et al. 2003

Clinical Autonomic Research

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“…CS in patients with FH (27.6%, severe CS 3.5%) did not increase with prolonged follow-up and is in accordance to results obtained by ESB2 [48]. In contrast to our findings, CS rates varying between 60% and 85.7% have been reported after T2-T3 sympathicotomy and lower T1 sympathicotomy and ESB [42,43,49]. Another disadvantage of T1 procedures is the high proportion of patients with Horner syndrome [54].…”

Section: Discussionsupporting

confidence: 54%

“…A few authors performed transection [42] or clip application [43] at the lower part of the stellate ganglion. Others tried to relieve patients with FH from their complaints via T2 sympathectomy [44][45][46][47] or T2 clipping [48].…”

Section: Surgical Treatment Strategiesmentioning

confidence: 99%

Surgical treatment of facial hyperhidrosis and blushing: mid-term results after endoscopic sympathetic block and review of the literature

et al. 2005

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Zusammenfassung. Grundlagen: Faziale Hyperhidrose (FH) und faziales "Blushen" (FB) sind durch gesteigerte Sympathikusaktivität verursachte Erkrankungen, die zu Dermatosen und psychischen Problemen führen. Patienten versuchen durch sozialen Rückzug derartige Attacken in der Öffentlichkeit zu vermeiden, wodurch eine Sozialphobie entstehen kann. Die limitierte endoskopische Sympathikusblockade (ESB) wurde als Therapie empfohlen, da neben einer möglichen Reversibilität eine Reduktion unerwünschter Begleiteffekte wie compensatorisches and gustatorisches Schwitzen (CS und GS) beschrieben wurde. Ergebnisse einer prospektiv erhobenen Datenbank von Patienten mit FB, die mittels ESB in Höhe von T2 und von solchen mit FH, die mittels ESB in Höhe von T3 versorgt wurden, werden präsentiert.Methodik: An 57 Patienten wurden 113 Eingriffe zwischen 6/2001 und 9/2004 durchgeführt. 27 Patienten mit FB und 30 mit FH wurden behandelt. Der mittlere Nachbeobachtungszeitraum betrug 20,4 Monate, Daten konnten von 96 % der Patienten erhoben werden. Behandlungserfolg, Patientenzufriedenheit und unerwünschte Begleiteffekte wurden evaluiert. Zusätzlich wird eine Über-sicht über Eigenheiten dieser Krankheitsbilder, deren pathophysiologischer Grundlage sowie über konservative und chirurgische Behandlungsformen geboten.Ergebnisse: Die Erfolgsrate war in beiden Gruppen annähernd gleich hoch. 96,2 % und 82,8 % der Patienten konnten vom FB und von FH geheilt werden. Weitere 3,8 % und 10,3 % gaben eine merkliche Verbesserung ihrer Beschwerden an. Die Patientenzufriedenheit war mit rund 80 % in beiden Gruppen gleich hoch, weitere 10 % waren zumindest großteils zufrieden. CS war selten verglichen mit anderen Methoden in der Sympathikuschirugie. Nur 23,1 % und 27,6 % der Patienten waren nach ESB2 beziehungsweise ESB3 betroffen. GS war relativ häufig (rund 50 %) in beiden Gruppen, beeinträchtigte die Patienten im täglichen Leben aber nicht.Schlussfolgerungen: Mittels endoskopischer Sympathikusblockade werden in der Behandlung von FB und FH hervorragende Erfolgsraten erzielt. Da die Rate an CS im Vergleich zu anderen Eingriffen in der Sympathikuschirurgie um rund 50 % niedriger ist, darf diese Art der chirurgischen Behandlung in jenen Fällen, wo konservative Therapiemaßnahmen versagen, ausdrücklich empfohlen werden.Schlüsselwörter: faziale Hyperhidrose, Erythrophobie, Sozialphobie, Sympathektomie, endoskopische Sympathikusblockade.Summary. Background: Facial hyperhidrosis (FH) and facial blushing (FB) are sympathetically mediated attacks causing dermatological diseases and psychological impairment. As a result, avoidant behaviour can lead to social phobia. Limited endoscopic sympathetic block (ESB) has been recommended, as potential reversibility and reduction of unwanted side-effects such as compensatory and gustatory sweating (CS and GS) have been described. We present midterm results of a prospectively collected database of patients treated by ESB at T2 for FB and at T3 for FH.Methods: 113 procedures (57 patients) were carried out from 6/2001 to 9/20...

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“…Kao et al [5] noted facial dryness in patients who had undergone T2 sympathectomy for the treatment of palmar hyperhidrosis, and recommended T2 sympathetic surgery in the treatment of craniofacial hyperhidrosis. Also other groups reported reduction of the incidence of Horner's syndrome after introduction of T2 sympathetic clipping in the treatment of facial hyperhidrosis [6,7].…”

Section: Discussionmentioning

confidence: 97%

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

Kim

Paik

Lee

2004

European Journal of Cardio-Thoracic Surgery

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Needlescopic thoracic sympathetic block by clipping for craniofacial hyperhidrosis

Abstract: Needlescopic thoracic sympathetic block by clipping is a safe and effective method for the treatment of craniofacial hyperhidrosis; compensatory sweating may be improved after a reverse operation and removal of the endo clips.

Cited by 23 publications

References 8 publications

Experience with limited endoscopic thoracic sympathetic block for hyperhidrosis and facial blushing

Experience with limited endoscopic thoracic sympathetic block for hyperhidrosis and facial blushing

Surgical treatment of facial hyperhidrosis and blushing: mid-term results after endoscopic sympathetic block and review of the literature

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

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