Palmar hyperhidrosis. Long-term results following high thoracic sympathectomy

Fourteen men and 22 wemon, with an average of 23 years (range 14-36 years) were operated on for hyperhidrosis of the upper extremity during the period from 1955 to 1970. Twenty-eight had had symptoms for more than 10 years. Resection of the 2nd and 3rd thoracic ganglia and the connecting sympathetic chain was carried out using a posterior approach; in 33 cases the operation was bilateral, and in three unilateral. Thirty-five patients were followed up after an average of 7.8 years (range 2-17 years). In one patient unilateral reoperation was carried out four months after the first operation. Since the first operation 34 patients had suffered from neither palmar nor axillary sweating. However 20 had permanent compensatory hyperhidrosis, and 15 suffered from gustatory facial sweating, which had usually started within six months of operation. Four, in whom two spinal thoracic nerves had also been resected, reported marked dysaesthesia over the front of the chest and in the axilla, lasting for several years.