Computed tomography guided thoracic sympatholysis for palmar hyperhidrosis
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Updated: Oct 29, 2026

Targeting Gray Rami Communicantes in Selective Chemical Lumbar Sympathectomy
Published on: January 10, 2019
A Lucas1, Y Rolland, N Journeaux
1Vascular Surgical Department, Hôpital Sud, C.H.R.U. de Rennes, France.
Methods:
Sixteen patients (mean age 26.3 years; range 18-38) with palmar hyperhidrosis underwent 29 sympatholyses after unsuccessful medical, and in 8 ionophoresis, treatments. Sympatholysis was performed under local anesthesia with computed tomographic guidance. After opacification of the injection site at T3 with Iopamiron 200, phenolization was performed with 10 ml 6% phenol.
Results:
Good immediate results evaluated on the basis of venous dilatation, and dryness and warmth of the skin were obtained in 23 cases (80%). There were 6 immediately unsuccessful procedures in 4 patients. At 20 months, good results, assessed on the basis of objective criteria and subjective patient self-evaluation were obtained in 22 cases (75% including immediate failures). Computed tomography guided thoracic sympatholysis performed under local anesthesia is an effective treatment for palmar hyperhidrosis. Morbidity is low and hospital stay is short.
Conclusions:
Our findings suggest that thoracic sympatholysis should be indicated as the first intention procedure when surgery is required in patients with palmar hyperhidrosis.
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