Percutaneous CT-guided chemical thoracic sympathectomy for patients with palmar hyperhidrosis after transthoracic endoscopic sympathectomy.
BACKGROUND
Palmar hyperhidrosis is a common functional disorder in the Asians. Currently, transthoracic endoscopic sympathectomy (TES) is considered to be the treatment of choice for this entity because of its high initial success rate and minimal morbidity. However, primary failure and recurrence of hyperhidrosis occurred in some patients, even with a very low incidence. We present our experience in the treatment of primary failure and recurrence of hyperhidrosis after TES by means of percutaneous computer tomography (CT) guided ethanol thoracic sympathectomy.


METHODS
From July 1999 to July 2001, 11 patients (2 males and 9 females with a mean age of 25.9 years, range: 19-44 years) of this subgroup underwent percutaneous CT-guided chemical thoracic sympathectomy. Failure of the first sympathectomy was caused by severe pleural adhesion (from the previous operative findings) in 7 patients. The remaining 4 patients were recurrent palmar hyperhidrosis. All patients underwent unilateral procedures (3 on the right and 8 on the left).


RESULTS
All patients were followed for at least 2 years after the treatment. Needle puncture was possible without difficulty in all patients. All patients had satisfactory results with minimal complication. No recurrence was noted at follow-up.


CONCLUSIONS
In summary, percutaneous CT-guided ethanol thoracic sympathectomy could be an easy, safe, and alternative strategy to treat patients with palmar hyperhidrosis after failure or recurrence after TES.
Lee
Kung-Shing
KS
Department of Neurosurgery, Jen-Ai Hospital, Taichung, Taiwan.
Chuang
Chih-Lin
CL
Lin
Chih-Lung
CL
Tsai
Ling-Chin
LC
Hwang
Shiuh-Lin
SL
Howng
Shen-Long
SL
D000328:Adult; D004724:Endoscopy; D005260:Female; D005728:Ganglia, Sympathetic / Q000000981:diagnostic imaging; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery / Q000628:therapy*; D008297:Male; D012008:Recurrence; D019233:Retreatment; D025321:Surgery, Computer-Assisted; D013562:Sympathectomy; D013563:Sympathectomy, Chemical; D013904:Thoracic Vertebrae / Q000294:innervation / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D016896:Treatment Outcome