CHEST Oct, 1999 by Kwang-Taik Kim, I H Kim, K Sun, I S Lee, H M Kim
Purpose: The study was designed prospectively to evaluate the effectiveness of T-3 sympathicotomy in treatment of palmar hyperhidrosis.
Methods: In the period from June to December 1998, fifty patients underwent T-3 sympathicotomy for palmar hyperhidrosis either in isolation (n=37) or in combination with axillary hyperhidrosis (n=13). Two patients of an isolated type were recurred cases after previous T-2 sympathectomy. Gender distribution was 24 males and 26 females, and the mean age was 20 years. The bilateral T-3 sympathetic trunks were severed by using 2 mm electrocoagulation scissors for an isolated type. T-4 sympathetic trunks were included bilaterally for a combined type. A linear analogue scale was used to assess the degree of sweating on the palms, face, trunk, and feet (ranged 0 to 10; 0 = anhidrosis vs. 10 excessive sweating) as well as the patient's satisfaction with surgery (ranged 0 to 10; 0 = regret vs. 10 = completely satisfied). The average follow-up period was 4.3 months.
Results: All patients were relieved from palmar hyperhidrosis. A mean palmar sweat production score after T-3 sympathicotomy was 1.5 [+ or -] 0.8. Some degree of compensatory sweating had occurred in 39 (78%) patients with a mean score of 3.4 [+ or -] 1.6. Gustatory sweating occurred in 2 (4%) patients. A mean score of patient's satisfaction with surgery was 8.5 [+ or -] 1.2.
Conclusion: Palmar hyperhidrosis can be successfully relieved by T3 sympathicotomy, which is favorably comparable with the results of T2 sympathicotomy.
Clinical Implications: When considering advantages of better preservation of facial sympathetic function, less occurrence of severe compensatory sweating, and lower incidence of gustatory sweating than T2 sympathicotomy, we would recommend T3 sympathicotomy as a treatment of choice for palmar hyperhidrosis.
Kwang-Taik Kim, MD(*); I H Kim, MD; K Sun, MD; I S Lee, MD and H M Kim, MD. Korea University Hospital, Seoul, Korea.
COPYRIGHT 1999 American College of Chest Physicians
COPYRIGHT 2000 Gale Group
