Injection of hot saline into sympathetic ganglia for palmar hyperhidrosis

Palmar hyperhidrosis is a disease frequently encountered in Vietnam. It is a severe social and professional handicap for the patient. More than 300 patients with palmar hyperhidrosis had been treated by classical upper thoracic sympathectomy in the Department of Neurosurgery in the Viet Duc Hospital up to May 1977. Faced with an increasing number of patients, a non-surgical treatment was therefore advocated. The technique consists of bilateral percutaneous injection of boiling saline into the paravertebral area containing the upper sympathetic ganglia. From May 1977 to January 1989, 600 patients were treated by this new technique. An objective reliable criterion of the success of the procedure is arterial vasodilatation in the upper limb, evidenced by pre- and postoperative Doppler studies and accompanied by dryness of the hands. Good results were obtained in 71% of the patients, bad results in 18% and relapse in 11%. Two major complications were Horner's syndrome (immediate in 14%, late in 1%) and compensatory hyperhidrosis (65%). The results show the effectiveness of non-surgical sympathectomy, with the advantages of greater simplicity and lower cost.