Compensatory Hyperhidrosis After Thoracoscopic Sympathectomy
Dr. Fritz Baumgartner
The Annals of Thoracic Surgery
Dumont et al(1) again raise the issue of compensatory sweating (CH) after thoracoscopic sympathectomy for hyperhidrosis, but leave unanswered the basic question of whether
the specific level of sympathectomy influences the frequency and severity of CH. Are there different rates and severities of CH between
sympathectomies at T2 alone, T3 alone, T2-3 combined, T2-4 combined, or T3-4 combined? No study has definitively shown a difference, and it is likely that the incidence
of CH at the various levels acceptance of CH is appropriate patient selection for the procedure. The patient's pre-and postoperative complaints.
Someone with massive, severe, palmar sweating who has surgery which cures his hands but causes severe back wetness will, nonetheless, be extraordinarily
happy with the surgery. Conversely, someone who has less severe palmar sweating who develops the same amount of postoperative back
wetness may be very disappointed. The level and intensity of the preoperative problem will determine what the patient is willing to endure
to achieve cure of the original problem.
In our experience, the ideal patients for thoracoscopic sympathectomy have the following four characteristics: (1) profound level of hand sweating,
to the point of dripping or near dripping; (2) near equal level of plantar to palmar hyperhidrosis, with or without severe
axillary hyperhidrosis; (3) spectacular exacerbation of palmar hyperhidrosis with application of ordinary hand lotion; (4) bimodal
time of onset of the disorder, either in early infancy or puberty. Although patients without all four of these characteristics have
received gratifying surgical success, it can be said with confidence that in patients who do have these four hallmarks, it would
be extremely rare to undergo curative thoracoscopic sympathectomy and have regrets after the operation, regardless of the
presence or absence of severe CH. It can be further stated with confidence that thoracoscopic sympathectomy is the treatment
of choice in these patients, and that no nonoperative treatment (including aluminum chloride, ionotophoresis, anticholinergics,
and Botulinum toxin injection), will have any significant long-term curative benefits whatsover(2,3). A family history of the disorder is a
strong corroborator as well, and was found in at least half of the patients in our series(2).
While surgical sympathectomy at various levels, usually between T2 to T3, is curative for palmar hyperhidrosis, the critical importance
of proper patient selection in achieving a true surgical success cannot be overestimated.
More Articles
Palmoplantar Hyperhidrosis Article-Added on April 11, 05
Management of Postsurgical Hyperhidrosis With Direct Current and Tap Water-Added on April 12, 05
16-year-old girl with sweating - Grand Rounds-Added on April 14, 05
Sympathectomy-Added on April 18, 05
Thoracoscopic Sympathectomy for Palmar Hyperhidrosis-Added on April 20, 05
Treatment of hyperhidrosis-Added on April 25, 05
Unilateral segmental hyperhidrosis associated with pulmonary adenocarcinoma-Added on April 28, 05
The Efficacy of the Drionic Device in the Treatment of Hyperhidrosis in Juvenile Amputees-Added on May 02, 05
Treatment of hyperhidrosis with botulinum toxin type-A improves quality of life - Washington Whispers - Brief Article-Added on May 03, 05
Management of hyperhidrosis -Added on May 05, 05
Thoracoscopic T-3 Sympathicotomy For Palmar Hyperhidrosis -Added on May 09, 05
FDA approves Botox for hyperhidrosis -Added on May 10, 05
Treating hyperhidrosis - Letter to the Editor -Added on May 11, 05
Hyperhidrosis - Letters to the Editor -Added on May 13, 05
Local neural block at the wrist for treatment of palmar hyperhidrosis with botulinum toxin: technical improvements
-Added on May 16, 05
Botox - Brief Article -Added on May 17, 05
No sweat: operation perspiration: extreme sweating can call for extreme treatment -Added on May 18, 05
Severe sweating treated with Botox-Added on May 19, 05
Botox approved for severe underarm sweating -Added on May 23, 05
Complications of procedure to correct sweating reported -Added on May 24, 05
How to deal with perspiration - Readers Helping Readers -Added on May 25, 05
Skin cream controls mealtime sweating -Added on May 26, 05
Staying dry is no sweat: what to do about excessive perspiration -Added on May 31, 05
Deodorant help eliminate - Want drier pits? - buying antiperspirants - controlling excessive perspiration - Brief Article -Added on June 01, 05
Sweating it out; the problem of profuse perspiration - includes related article on deodorants -Added on June 02, 05
Botox Is An Effective Treatment for Excessive Sweating -Added on June, 08
Don't sweat it: there's more to wetness protection than sticks and sprays. Before you reach for that roll-on, read on -Added on June, 09
Embarrassing body bummers: Bad breath. Facial hair. Excessive sweating. New solutions for these and other problems that make you blush - Health -Added on June, 10
Easy ways to stay dry: I can't stop sweating through my clothes. What can help?… And more of your questions answered here -Added on June, 13
Sweating the small stuff - and big - Your Life - Brief Article -Added on June, 14
Reminder - OR-Live.com Presents: Hope for Excessive Sweating: Robert Wood Johnson University Hospital to Webcast, LIVE, a Hyperhidrosis Procedure -Added on June, 16
OR-Live.com Presents: Hope for Excessive Sweating: Robert Wood Johnson University Hospital to Webcast, LIVE, a Hyperhidrosis Procedure -Added on June, 23
Hyperhidrosis or Excessive Sweating
What is hyperhidrosis?Where does hyperhidrosis occur?
What are the symptoms of hyperhidrosis?
What are the alternative treatments for hyperhidrosis?
Is there a surgical treatment for hyperhidrosis?
|
Boston, Massachussetts
"It's so awesome! I'm really glad I went to cure my hyperhidrosis. It's great to be able to go to the gym
and not sweat on my hands, face, head, or feet. Thank you so much!" |
Reno, Nevada
"Thank you, for curing of my hyperhidrosis. Your staff was compassionate, caring,
and very professional. You made me feel like family. I was attended to in a prompt and hospitable manner.
Everything was thoroughly explained in detail to me. I can't wait to tell everyone how successful my
surgery was! You are definitely a |
|
Irvine, California
"As a little boy, I already had sweaty palms. I was miserable because this condition
had been with me all my life. I dreaded attending church or social gatherings
because it meant I had to face others. Also, I had difficulty handling tools at
work because everything I touched became wet. I am very happy with the result
of my surgery. Thanks for curing my hyperhidrosis. I feel years
younger. I highly recommend Hyperhidrosis Center™ to anyone who is suffering from palmar hyperhidrosis."
|
Helena, Montana
"I tried medicines--from Beta Blockers--to lotions--to antipsychotics, but to no avail.
I was using Drysol. At the beginning it was great. I had dry hands for two
weeks in- between doses. Then slowly, the medication started to lose its affect
on me. Instead of applying once every two weeks it was once every two days.
I started to look on the Internet for other alternatives and found the website for the treating hyperhidrosis."
|
|
Waikiki, Hawaii "I strongly suggest that anyone suffering from sweaty palms should consult
the doctor to have the surgery. I suffered from this problem for more than
20 years, and now there is no more hyperhidrosis." |
Houston, Texas "I am very happy to come to California to have removal of my hyperhidrosis. Both my hands and feet are now dry. If anyone in
the Houston, Texas area would like to talk with me, it's okay. Please
call Hyperhidrosis Center™ at 1-866-PALM-911 for my number."
|
