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Temporary thoracoscopic sympathetic block for hyperhidrosis.

Daniel L Miller1, Seth D Force

  • 1Section of General Thoracic Surgery, Department of General Surgery, Emory University School of Medicine, Atlanta, Georgia 30322, USA. daniel.miller@emoryhealthcare.org

The Annals of Thoracic Surgery
|March 22, 2008
PubMed
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A temporary thoracoscopic sympathetic block accurately predicts compensatory hyperhidrosis (CH) after sympathectomy for primary hyperhidrosis (PH). This reversible procedure helps patients decide on irreversible sympathectomy, reducing CH fears.

Area of Science:

  • Thoracic surgery
  • Neurosurgery
  • Dermatology

Background:

  • Compensatory hyperhidrosis (CH) is a common, often feared, side effect of thoracoscopic sympathectomy.
  • The irreversibility of sympathectomy and unreliable clip removal for CH reversal necessitate predictive methods.
  • Patients with primary hyperhidrosis (PH) often avoid sympathectomy due to CH concerns.

Purpose of the Study:

  • To evaluate a temporary thoracoscopic sympathetic block as a predictive tool for postsympathectomy CH.
  • To assess the safety and efficacy of this reversible block before definitive sympathectomy.

Main Methods:

  • Retrospective review of patients undergoing temporary thoracoscopic sympathetic block followed by sympathectomy for medically refractory PH.
  • Bilateral thoracoscopic sympathetic blockade at T2, T3, and accessory nerve levels using marcaine with epinephrine.

Related Experiment Videos

  • Assessment of temporary hyperhidrosis relief and occurrence of CH post-block.

    • Main Results:

    • Twenty-five patients underwent the procedure; 12% experienced temporary CH post-block (2 mild, 1 severe).
    • All patients who proceeded to sympathectomy were cured of hyperhidrosis (100%).
    • Mild CH post-block correlated with mild CH post-sympathectomy; patients remained satisfied.

    Conclusions:

    • Temporary thoracoscopic sympathetic block is a safe, reversible, and accurate method to predict CH after sympathectomy.
    • This technique offers a viable solution for PH patients concerned about developing CH, improving treatment decisions.