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Severe hyperhidrosis: clinical features and current thoracoscopic surgical management
Fritz J Baumgartner1, Youn Toh
1Center for the Cure of Sweaty Palms, Santa Ana, California, USA.
The Annals of Thoracic Surgery
|December 12, 2003
Summary
Thoracic sympathectomy offers a highly effective outpatient treatment for severe hyperhidrosis, particularly palmar hyperhidrosis. While it provides significant relief for plantar and axillary sweating, compensatory sweating is a common side effect.
Area of Science:
- Medical Sciences
- Surgical Procedures
- Dermatology
Background:
- Severe hyperhidrosis is a debilitating condition affecting palms, soles, and underarms.
- Outpatient thoracoscopic sympathectomy is a surgical option for managing severe hyperhidrosis.
Purpose of the Study:
- To review patient characteristics, surgical techniques, and outcomes of thoracoscopic sympathectomy for hyperhidrosis.
- To evaluate the effectiveness of T2-T3 sympathectomy for palmar, plantar, and axillary hyperhidrosis.
Main Methods:
- A series of 309 patients underwent thoracoscopic T2-T3 sympathectomy.
- 180 patients were prospectively evaluated for pre- and postoperative features.
Main Results:
- Thoracoscopic sympathectomy achieved near-instantaneous and complete cure for palmar hyperhidrosis in 100% of patients.
- Significant improvement was observed in plantar hyperhidrosis (84.4%) and axillary hyperhidrosis (69.4%).
- Severe compensatory hyperhidrosis occurred in only 1.3% of patients, though mild to moderate CH was reported in 45%.
Conclusions:
- T2-T3 sympathectomy is curative for palmar hyperhidrosis and improves plantar hyperhidrosis.
- Surgical outcomes for axillary hyperhidrosis are less effective than for palmar hyperhidrosis.
- Bilateral thoracoscopic sympathectomy is a safe and effective outpatient procedure for hyperhidrosis.