[Thoracoscopic sympathectomy in the treatment of palmar hyperhidrosis and facial blushing].
BACKGROUND
Severe palmar hyperhidrosis and facial blushing are conditions connected with considerable psychosocial burden. Conservative treatment is often of limited value. Several reports have demonstrated high success rates in thoracoscopic sympathectomy. Treatment results from Norwegian centres have not previously been published.


METHODS
The long term effects of thoracoscopic sympathectomy performed between 1998 and 2002 at Aker University Hospital were evaluated by questionnaire, using VAS scores (visual analogue scales) obtained from 72 out of 76 operated patients.


RESULTS
In palmar hyperhidrosis, a reduction in VAS score above 3 was reported in 27 of 28 patients (from mean 9.5 +/- 0.2 to 0.8 + 0.4). In facial blushing, 39 of 44 patients reported a reduction in VAS score above 3 (from mean 8.9 +/- 0.3 to 2.5 +/- 0.4). The overall satisfaction rate was 90 %. A majority of patients (86 %) experienced variable but lasting compensatory general hyperhidrosis. However, only a few patients found this condition disabling to the extent that it caused regret (3 patients) or dissatisfaction (4 patients).


CONCLUSIONS
Thoracoscopic sympathectomy markedly reduces palmar hyperhidrosis and facial blushing, but the indication should be strong and the information thorough because of compensatory hyperhidrosis.
Saetre
Torunn
T
Oslo karkirurgiske senter, Aker universitetssykehus, 0514 Oslo. torusa@online.no
Flørenes
Tor
T
D000293:Adolescent; D000328:Adult; D001821:Blushing; D005260:Female; D006225:Hand; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D013562:Sympathectomy / Q000379:methods*; D013906:Thoracoscopy / Q000379:methods*; D016896:Treatment Outcome