Treatment of Palmar Hyperhidrosis

Chang, Yu‐Tang; Li, Hsien-Pin; Lee, Jui‐Ying; Lin, Pei-Jung; Lin, Chien-Chih; Kao, Eing-Long; Chou, Shah‐Hwa; Huang, Meei-Feng

doi:10.1097/sla.0b013e3180caa466

Cited by 65 publications

(29 citation statements)

References 19 publications

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“…The most imperative notion about nerve disruption is that there is adequate separation between the ends of the chain so that regeneration is halted. Although resection yields better results in terms of lower recurrence rates, most ETS procedures prefer ganglionic thermo-ablation or thermo-transection of the chain due to the relative simplicity of the latter rather than endoscopic resection 28 – 30 .…”

Section: Introductionmentioning

confidence: 99%

A retrospective review on minimally invasive technique via endoscopic thoracic sympathectomy (ETS) in the treatment of severe primary hyperhidrosis: Experiences from the National Heart Institute, Malaysia

et al. 2018

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Background: Hyperhidrosis is due to the hyperactive autonomic stimulation of the sweat glands in response to stress. Primary hyperhidrosis is a common yet psychologically disabling condition. This study will describe our experience in managing hyperhidrosis via endoscopic thoracic sympathectomy (ETS). Methods: The information was obtained from the patient records from 1st January 2011 until 31st December 2016. Pertinent information was extracted and keyed into a study proforma. Results: 150 patients were operated on but only 118 patients were included in this study. The mean age was 22.9±7.3 years. The majority (54.2%) had palmar-plantar hyperhidrosis and 39.8% had associated axillary hyperhidrosis. Excision of the sympathetic nerve chain and ganglia were the main surgical technique with the majority (55.9%) at T2-T3 level. Mean ETS procedure time was 46.6±14.29 minutes with no conversion. Surgical complications were minimal and no Horner’s Syndrome reported. Mean hospital stay was 3.5±1.05 days. The majority of patients (67.8%) had only one follow-up and only half of the study sample (58.5%) complained mild to moderate degree of compensatory sweating, even though the long-term resolution is yet to be determined by another study. Following ETS, 98.3% of patients had instant relief and resolved their palmar hyperhidrosis. Predictors of CS were sympathectomy level and follow-up. The odds of reporting CS was 2.87 times in patients undergoing ETS at the T2-T3 level compared to those undergoing ETS at the T2-T4 level. The odds of reporting CS was 13.56 times in patients having more than one follow-up compared to those having only one follow-up. Conclusion: We conclude that ETS is a safe, effective and aesthetically remarkable procedure for the treatment of primary hyperhidrosis with only half of the patients developing mild to moderate degree of CS. Significant predictors of CS were sympathectomy level during ETS and frequency of follow-up after ETS.

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Section: Introductionmentioning

confidence: 99%

A retrospective review on minimally invasive technique via endoscopic thoracic sympathectomy (ETS) in the treatment of severe primary hyperhidrosis: Experiences from the National Heart Institute, Malaysia

et al. 2018

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“…Therefore, the incidence of complications is lower than that observed with ramicotomy. In this study, the patients who underwent sympathicotomy had better outcomes than those who underwent ramicotomy(Table 5) [6, 16, 17]. Recently, T4 sympathicotomy has been reported to be superior to T3 sympathicotomy, because it results in reduced CS and only slight hand moisture.…”

Section: Discussionmentioning

confidence: 79%

A comparison between two types of limited sympathetic surgery for palmar hyperhidrosis

et al. 2012

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PurposeEndoscopic thoracic sympathetic surgery is effective for treating palmar hyperhidrosis, although compensatory sweating (CS) is a significant and annoying side effect. The purpose of this study was to compare the results of limited resection at two different locations.MethodsFrom May 2004 to June 2009, T3 sympathicotomy (group I) was performed in 46 patients and T3,4 ramicotomy (group II) was performed in 43 patients during the same period. T3 sympathicotomy (group I) and T3,4 ramicotomy (group II) were performed during the same period. Using questionnaires, completed by the patients, the satisfaction rates and grades of CS were analyzed.ResultsNo significant differences in age distribution or sex ratios were observed between the two groups. The satisfaction rate was 91.3 % in group I and 79.1 % in group II. The operation time was 19.8 (±6.6) min in group I, and 51.6 (±18.8) min in group II, showing a statistically significant difference (p < 0.002). The incidence of persistent hand sweating in group II (16.3 %) was higher than that observed in group I (2.2 %). The incidence of compensatory sweating on the lower extremities was higher in group II (37.2 %) than in group I (10.9 %).ConclusionsAlthough ramicotomy is considered to be an effective method for treating hyperhidrosis and has a theoretical advantage of allowing greater anatomical resection, it requires longer operation time and induces more severe compensatory sweating in the lower limbs resulting in reduced satisfaction rates.

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“…Severe CH is a debilitating condition primarily affecting the trunk (back, 75% of patients; abdomen, 51% of patients; and chest, 13% of patients), feet (23% of patients), groin and thighs (13% of patients), and axillary regions (8% of patients) that may develop in some patients (4–6% of patients) depending on the type of surgical procedure received 5,17 . CH can cause severe psychological, medical, and occupational problems resulting from heavy sweating that can soak through clothing.…”

Section: Discussionmentioning

confidence: 99%

“…Sympathectomy is considered to be the most effective treatment for patients with palmar hyperhidrosis who want to achieve permanent resolution of their condition. Although data supporting the clinical efficacy of sympathectomy are plentiful, the most common and troublesome side effect is CH, which occurs in as many as 89% of patients with a mild to moderate level of severity 4–6 . However, CH is so serious in 35% of patients after surgical sympathectomy that they often have to change their clothes during the day.…”

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Yoon

et al. 2009

Dermatologic Surgery

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Treatment of Palmar Hyperhidrosis

Abstract: Different from the current procedure of T(2) or T(3) sympathectomy for palmar hyperhidrosis, T(4) sympathectomy would be a better and more effective procedure with minimal long-term complications.

Cited by 65 publications

References 19 publications

A retrospective review on minimally invasive technique via endoscopic thoracic sympathectomy (ETS) in the treatment of severe primary hyperhidrosis: Experiences from the National Heart Institute, Malaysia

A retrospective review on minimally invasive technique via endoscopic thoracic sympathectomy (ETS) in the treatment of severe primary hyperhidrosis: Experiences from the National Heart Institute, Malaysia

A comparison between two types of limited sympathetic surgery for palmar hyperhidrosis

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