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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
PubMed
Summary

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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.
Keywords:
DysautonomiaHyperhidrosisSympathectomySympatholysis

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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.