title: Prospective study of percutaneous radiofrequency sympathicolysis in severe hyperhidrosis and facial blushing: efficacy and safety findings.
abstract: OBJECTIVE
  Hyperhidrosis (Hh) and facial blushing (Fb) are conditions caused by hyperactivity of the sympathetic system; they affect around 2% of the population. Severe cases have been typically treated with thoracic sympathectomy through a minimally invasive approach. We sought to determine if severe Hh and/or Fb patients, who are reluctant to go through an operation with general anaesthesia, could benefit from receiving percutaneous radiofrequency ablation of the sympathetic chain.
  
  
  METHODS
  Prospectively collected data obtained from May 2007 to May 2010 were analysed to compare the treatment efficacy and effects on quality of life of the two procedures.
  
  
  RESULTS
  From a total of 58 patients enrolled in the study, 31 were treated with radiofrequency procedures, whereas 27 received surgical sympathectomy. Patients with Hh had better results with surgery than with radiofrequency sympathicolysis in terms of efficacy (p=0.0001) and quality of life (p=0.0002). However, there was still a significant improvement in quality of life in the group of patients treated with radiofrequency sympathicolysis (p=0.004). Patients with Fb had good results with surgical procedures and poor outcomes with radiofrequency ablation, resulting in significant differences in treatment efficacy (p=0.005) and in quality of life (p=0.003). Fb patients treated with radiofrequency procedures had no improvement in quality of life after the intervention (p=0.28).
  
  
  CONCLUSIONS
  Our results support the view of surgical sympathectomy as the gold-standard treatment in severe cases of Hh and Fb. Radiofrequency sympathicolysis is useful as a second-treatment choice for Hh patients. Fb patients do not benefit from radiofrequency sympathicolysis.
authors.affiliation: General Thoracic Surgery Department, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain. c.garciafranco@hotmail.com
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Garcia Franco
authors.forename: Juan
authors.initials: J
authors.lastname: Perez-Cajaraville
authors.forename: Francisco
authors.initials: F
authors.lastname: Guillen-Grima
authors.forename: Agustin
authors.initials: A
authors.lastname: España
mesh_terms: D000293:Adolescent; D000328:Adult; D001821:Blushing; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D013562:Sympathectomy / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult