Thoracoscopic sympathectomy for hyperhidrosis: analysis of 642 procedures with special attention to Horner's syndrome and compensatory hyperhidrosis

Neurosurgery
Scott D WaitCurtis A Dickman

Abstract

Hyperhidrosis (HH) profoundly affects a patient's well-being. We report indications and outcomes of 322 patients treated for HH via thoracoscopic sympathectomy or sympathotomy at the Barrow Neurological Institute. A prospectively maintained database of all patients who underwent sympathectomy or sympathotomy between 1996 and 2008 was examined. Additional follow-up was obtained in clinic, by phone, or by written questionnaire. A total of 322 patients (218 female patients) had thoracoscopic treatment (mean age 27.6 years; range, 10-60 years). Mean follow-up was 8 months. Presentations included HH of the palms (43 patients, 13.4%), axillae (13 patients, 4.0%), craniofacial region (4 patients, 1.2%), or some combination (262 patients, 81.4%). Sympathectomy and sympathotomy were equally effective in relieving HH. Palmar HH resolved in 99.7% of patients. Axillary or craniofacial HH resolved or improved in 89.1% and 100% of cases, respectively. Hospital stay averaged 0.5 days. Ablating the sympathetic chain at T5 increased the incidence of severe compensatory sweating (P = .0078). Sympathectomy was associated with a significantly higher incidence of Horner's syndrome compared with sympathotomy (5% vs 0.9%, P = .0319). Patients reporte...Continue Reading

References

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Citations

Jan 22, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hua TangXuewei Zhao
Oct 4, 2016·Thoracic Surgery Clinics·Joel M Sternbach, Malcolm M DeCamp
Feb 20, 2021·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Dania NachiraStefano Margaritora

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