Prevalance of hyperhidrosis is 2-3 percent. Approximately 30 to 65% of patients have positive family history. Whereas hyperhidrosis is most common in armpits, it can be seen in multiple localizations, such as hand, foot and face.
There are various treatment methods, including local, systematic and surgical therapies. Local and systematic therapies are not superior to surgical treatment. For mild cases, cream and lotions can be used, while iontophoresis and botulinum toxin are reserved for moderate cases. Those therapeutic options can be applied by Dermatologists and Plastic Surgeons. Definitive and permanent recovery is achieved by surgical treatment.
The surgical method is Endocopical Thoracic Sympathetic Blockage (ETS).
Endocopical Thoracic Sympathetic Blockage (ETS)
As a type of blockage, one of procedures written below can be used;
3. Placement of clip.
Since it is an endoscopic procedure, two small
ports are opened in the armpit. Endoscopic camera is advanced and a
clip is placed on the sympathetic nerve, which regulates
perspiration. Or preferably, the sympathetic nerve can be coagulated
or divided with electrocautery. This operation lasts 30 minutes and
is carried out under general anesthesia.
Success Rates are
- 90-95% in sweaty hands
- 85-90% in armpit sweating
- 80% in facial sweating.
Additionally, 25% regression is observed in foot sweating and facial flashing.
Heavy perspiration is postoperatively eliminated in hyperhydrosis zones, while normal perspiration function is maintained in other body parts. Endoscopic operation is a safe method and is accompanied by low complication rate.
Possible Side Effects
- Reflexive Perspiration
- Dry skin
- Gustatorial sweating
- Decrease pulse
- Horner Syndrome
- Pain at incision site
- Slight weakness
The most disturbing one among them is the reflexive perspiration. Reflexive perspiration is seen in 12% of all patients. In some patients, it can be manifested by increased perspiration in abdomen, waist and legs secodary to the reaction of body.
Patient may require stay in hospital for 8 to 10 hours or somestimes for 24 hours after the operation. Patient will be fit to fly and can take shower 48 hour after the operation. They can go back to work in postoperative Day 7.
Endocopical Thoracic Sympathetic Blockage (ETS) is not an option for some patients.
are the ones;
1. Having generalized body perspiration
2. Night sweating
3. Having history of lung surgery
4. Having pleural adhesion.
The operation does not result with cessation of perspiration in total body. Sweating is eliminated at localizations where hyperhydrosis is present. Perspiration function is maintained in other body parts.
Endocopical Thoracic Sympathetic Blockage (ETS) is performed sequentially for bilateral armpits.