Surgical management of patients with hyperhidrosis

Eighteen patients with hyperhidrosis affecting different anatomical areas were treated with a variety of surgical methods. Bilateral axillary gland excision is an appropriate and cosmetically acceptable method of treating axillary hyperhidrosis (11 patients). Bilateral supraclavicular cervical sympathectomy was performed for excessive sweating of the hands (7 patients). Bilateral lumbar sympathectomy was necessary in only 3 patients with excessive sweating of the feet. When perineal hyperhidrosis is present, the first lumbar ganglia must be excised. Transaxillary, transpleural sympathectomy, removing the first to fourth thoracic ganglia, is successful in treating failures of sweat gland excision or troublesome sweating of hands and axillae.