Comparison Between T2 and T2.3 Thoracic Sympathetic Block in Palmar Hyperhidrosis

Sung, Sook Whan; Jo, Kwang Ree; Kim, Young Tae; Kim, Joo Hyun

Abstract

BACKGROUND: Thoracoscopic sympathetic block in palmar hyperhidrosis has merits in its immediate responsiveness and recovery. In palmar hyperhidrosis, the level of sympathetic chain to be blocked has been somewhat obscure. MATERIALS AND METHODS: To compare the results of T2 with T2,3 sympathetic block, we retrospectively studied 192 patients (T2 group: 84, T23 group: 108) operated on at SNUH with palmar hyperhidrosis between April 1994 and July 1997. We reviewed medical records and recently interviewed the patients by telephone call. Sex and age distribution between two groups showed no significant differences. We performed sympathectomy at the early phase of the syudy until April 1997, and after then, we adopted sympathicotomy rather than sympathectomy. RESULTS: All patients showed symptomatic improvement after the operation. Mean operation times of T2, T23 groups were 61.3+/-22.5min, 82.7+/-24.8min, respectively (p<0.01). Early postoperative complications, such as Horner's syndrome or chest tube insertion, were not different in two groups. There were no statistical differences of late complications such as compensatory truncal hyperhidrosis, gustatory sweating, and phantom sweating. No patient experienced recurrence of palmar hyperhidrosis during the study period. The only difference was the extent of compensatory truncal hyperhidrosis. The compensatory sweating occurred from axilla to suprapatella in T2 group whereas its extent was from nipple to suprapatella in T23 group.
CONCLUSIONS
We concluded that T2 thoracic sympathetic block is mandatory for the treatment of primary palmar hyperhidrosis.