Related Experiment Videos
CT-Guided, Percutaneous Ethanol Sympatholysis for Primary Hyperhidrosis
Malcolm Brock1, Constantine Frangakis2, Christos S Georgiades3
1Thoracic Surgery, Center for Sweat Disorders, 1800 Orleans St., Sheikh Zayed Tower, Baltimore, MD, 21287, USA.
Cardiovascular and Interventional Radiology
|October 18, 2017
Summary
CT-guided sympatholysis offers effective treatment for primary hyperhidrosis (PH) in craniofacial and axillary-palmar regions. This minimally invasive procedure demonstrated favorable safety and efficacy rates at 18 months.
Area of Science:
- Interventional Radiology
- Neurosurgery
- Dermatology
Background:
- Primary hyperhidrosis (PH) significantly impacts quality of life, affecting craniofacial (CF) and axillary-palmar (AP) regions.
- Current treatment options for PH may have limitations in efficacy or side effect profiles.
Purpose of the Study:
- To evaluate the safety and efficacy of CT-guided percutaneous sympatholysis for treating craniofacial and axillary-palmar primary hyperhidrosis.
Main Methods:
- A prospective study involving 39 patients with CF or AP PH undergoing CT-guided sympatholysis.
- Neurolysis was performed using ethanol after lidocaine testing for Horner syndrome, targeting T2 for CF and T2-T4 for AP PH.
- Patients were monitored post-procedure with follow-ups at 1 week, 1 month, and as needed, with complications graded by CTCAE.
Main Results:
- Technical success was 100% in 38 eligible patients (mean age 38 years, 18-month follow-up).
- Overall efficacy was 60%, with 72% for CF PH and 50% for AP PH.
- Three major complications occurred: two pneumothoraces and one case of severe intercostal neuralgia.
Conclusions:
- CT-guided sympatholysis provides a safe and effective treatment option for primary hyperhidrosis in the craniofacial and axillary-palmar areas.
- The procedure achieved notable 18-month efficacy rates of 72% for CF PH and 50% for AP PH.
- The risk profile associated with CT-guided sympatholysis is considered favorable.