Compensatory hyperhidrosis: a consequence of truncal sympathectomy treated by video assisted application of botulinum toxin and reoperation.
Hyperhidrosis is a debilitating condition characterised by sweating that exceeds the need of normal thermoregulation. Surgical management of primary hyperhidrosis by upper dorsal sympathectomy is the treatment of choice for intractable hyperhidrosis, however, paradoxically it may be followed by troublesome compensatory hyperhidrosis in a significant number of patients. The frequency of compensatory hyperhidrosis often reflects the extensiveness of the denervation. We report for the first time the successful treatment of a patient who developed compensatory hyperhidrosis following sympathectomy using video assisted extension of the sympathectomy by application of botulinum toxin (BTX-A). In addition, this case highlights the use of botulinum toxin as a guide for the potential successful management of compensatory hyperhidrosis prior to definitive extension of a sympathectomy.
Efthymiou
Christopher Andrew
CA
Department of Thoracic Surgery, St James' Hospital, Beckett Street, Leeds, LS9 7TF, United Kingdom.
Thorpe
James Andrew Charles
JA
D000328:Adult; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D008297:Male; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D012008:Recurrence; D012086:Reoperation / Q000379:methods; D013562:Sympathectomy / Q000009:adverse effects*; D020535:Video-Assisted Surgery / Q000379:methods
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A