CT-Guided, Ethanol Sympatholysis for Primary Axillary-Palmar Hyperhidrosis

Area of Science:

• Interventional Radiology
• Neurosurgery
• Dermatology

Background:

• Primary hyperhidrosis involves excessive sweating due to sympathetic nervous system overactivity.
• Current treatments may have limitations, necessitating exploration of novel interventions.

Purpose of the Study:

• To evaluate the feasibility of CT-guided sympatholysis for treating primary hyperhidrosis.
• To gather preliminary data on the safety and efficacy of this minimally invasive procedure.

Main Methods:

• Nine patients with axillary-palmar hyperhidrosis underwent CT-guided bilateral sympathetic blockade using alcohol.
• Procedures were performed under local anesthesia, with immediate post-procedure CT scans to assess complications.
• Technical and clinical success, along with efficacy (primary and secondary), were evaluated over a median 12-month follow-up.

Main Results:

• CT-guided sympatholysis was technically successful in 89% of patients, with immediate cessation of sweating in all treated individuals.
• Two major complications occurred (one pneumothorax requiring a chest tube).
• Recurrence was observed in three patients, with two successfully retreated. No cases of Horner's syndrome or compensatory hyperhidrosis were noted.

Conclusions:

• CT-guided alcohol sympatholysis is a feasible option for axillary/palmar primary hyperhidrosis.
• The procedure demonstrated high efficacy (75% primary, 94% secondary) at a median 1-year follow-up.
• The risk profile appears favorable, supporting further investigation in larger studies.