Effectiveness of Bilateral Clipping of the Thoracic Sympathetic Chain for the Treatment of Severe Palmar and/or Axillary Hyperhidrosis and Facial Flushing

Alfara, Juan José Fibla; López-Rodó, Laureano Molins; Ferrández, Jorge Hernández; Montes, Angela Guirao

doi:10.1016/j.cireng.2019.04.002

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…Se concluyó que el "clipping" es un procedimiento efectivo y permite reversión de hiperhidrosis compensatoria al retirarlos. Sin embargo, a nivel nacional y por consenso de experiencia no se utiliza la simpatectomía con uso de clips, ya que estos por necrosis e isquemia de la fibra simpática se desprenden con el paso de los meses y se pierde la eficacia del efecto en la hiperhidrosis de la cirugía (14).…”

Section: Manejo Quirúrgico: Simpatotomía Torácica Videoasistidaunclassified

Hiperhidrosis

Solís¹,

Cabezas²,

Barrantes³

2022

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La hiperhidrosis es una condición de sudoración excesiva, que puede deberse a causas primarias o secundarias. De forma primaria es provocada en una gran mayoría de los casos por una disfunción autonómica, que lleva a un control deficiente de la sudoración emocional durante la vigilia. En los casos secundarios se debe a factores fisiológicos, patológicos, medicamentosos o por toxinas, que pueden causar una sudoración excesiva, durante tanto el sueño como la vigilia. Es una condición de la cual no hay datos epidemiológicos tan claros, ya que las personas no tienden a consultar por esto. Existen diversos tratamientos que se pueden utilizar, inicialmente antiperspirantes tópicos, algunos tratamientos sistémicos, inyecciones de toxina botulínica y finalmente, en algunos casos se recurre al manejo quirúrgico.

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Section: Manejo Quirúrgico: Simpatotomía Torácica Videoasistidaunclassified

Hiperhidrosis

Solís¹,

Cabezas²,

Barrantes³

2022

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“…Some have tried applying clips instead of irreversibly damaging the nervous tissue [30]. In bothersome CH, these clips can be removed and wait to hope for improvement [31]. Unfortunately, this is not always the case [32,33].…”

Section: Introductionmentioning

confidence: 99%

Selective T3-T4 Sympathicotomy Versus Gray Ramicotomy On Outcome And Quality Of Life In Hyperhidrosis Patients. A Randomized Clinical Trial.

Vanaclocha

Guijarro-Jorge

Saiz-Sapena

et al. 2021

Preprint

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Background: compensatory hyperhidrosis is the leading cause of patients' dissatisfaction after thoracic sympathicotomy.Objective: to reduce compensatory hyperhidrosis to increase patients' satisfaction. Patients and methods: a prospective randomized study on palmar hyperhidrosis, May 2016-September, 2019. Twenty-one patients T3-T4 sympathicotomy and 21 T3-T4 gray ramicotomy. Data prospectively collected. Analysis at study's end. Focus on the sweating, temperature, quality of life baseline and postoperatively, compensatory hyperhidrosis, hand dryness, patients' satisfaction, and if they would undergo the procedure again and would recommend it.Results: No baseline differences between groups. Hyperhidrosis was controlled postoperatively in all patients. No mortality, serious complications, or recurrences. Sympathicotomy worse postoperative quality of life (49.05 (SD: 15.66, IR: 35.50-63.00) versus ramicotomy 24.30 (SD: 6.02, IR: 19.75-27.25). After ramicotomy, some residual sweating on the face, hands, and axillae. Compensatory sweating worse with sympathicotomy. Satisfaction higher with ramicotomy. Better results with ramicotomy than sympathicotomy regarding hand dryness, how many times a day the patients had to shower or change clothes, intention to undergo the procedure again or recommend it to somebody else, and how bothersome compensatory hyperhidrosis was.Conclusions: T3-T4 gray ramicotomy had better results than T3-T4 sympathicotomy, with less compensatory sweating and higher patients' satisfaction.

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To avoid compensatory hyperhidrosis after sympathetic surgery for craniofacial hyperhidrosis

et al. 2020

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Background: Endoscopic thoracic sympathectomy (ETS) has not been widely adopted for treating craniofacial hyperhidrosis (CFH) due to its known postoperative complication, compensatory hyperhidrosis (CH). In this study, we evaluated whether the autonomic nerve analysis data via pre-ETS heart rate variability (HRV) test can predict post-ETS CH in patients with CFH.Methods: From October 2017 to March 2019, we consecutively included CFH patients who underwent ETS and received preoperative HRV. In this prospective observational study, we evaluated those who developed CH 3 months postoperatively. The CH grades were categorized into none, mild, moderate, and severe.Results: A total of 53 patients were included; the mean age was 42.5±13.2 years, and there were 41 males (77.4%). Twenty-six (49.1%) patients had a post-ETS CH grade of greater than moderate (moderate and severe). We further classified the group into trivial and serious compensation, based on the CH grade for comparison. Among the various HRV values, low frequency/high frequency (LF/HF) value was the only one that achieved statistical significance (P=0.025). Moreover, among those in the trivial compensatory group, 23 (85.2%) patients had an LF/HF value between 0.66 and 2.60, and therefore, were included in the autonomic balanced group. On the other hand, among those in the serious compensatory group, 24 patients (92.3%) had an LF/HF value of less than 0.66 and greater than 2.60, and thus, in the autonomic dysfunction group.Conclusions: According to the present study, HRV test, especially the HF/LF value, appears to be a useful test in predicting post-ETS serious CH.

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Effectiveness of Bilateral Clipping of the Thoracic Sympathetic Chain for the Treatment of Severe Palmar and/or Axillary Hyperhidrosis and Facial Flushing

Cited by 3 publications

References 32 publications

Hiperhidrosis

Hiperhidrosis

Selective T3-T4 Sympathicotomy Versus Gray Ramicotomy On Outcome And Quality Of Life In Hyperhidrosis Patients. A Randomized Clinical Trial.

To avoid compensatory hyperhidrosis after sympathetic surgery for craniofacial hyperhidrosis

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