Clincal Results according to the Level and Extent of Sympathicotomy in Axillary Hyperhidrosis

Kim, Byung Ho; Huh, Dong Myung

Abstract

BACKGROUND: Video-assisted thoracic sympathicotomy plays an important role as an effective method for the treatment of axillary hyperhidrosis. People with axillary hyperhidrosis were not satisfied by the occurrence of the high rate of disabling compensatory hyperhidrosis and axillary resweating. Therefore, by comparing and assessing the clincal results according to the level and extent of sympathicotomy in axillary hyperhidrosis, we aim to determine which method will result in maximal benefits. MATERIAL AND METHOD: Among 70 patients suffering from axillary hyperhidrosis having undergone thoracoscopic sympathicotomy from January 2001 through December 2003, 57 patients who responded to either telephone interview or questionnaire were included in the current study. The patients were divided into two groups, Group I (n=25): patients having undergone R3, 4, 5 sympathicotomy which consist of blocking the interganglionic neural fiber on the third, fourth, and fifth rib, Group II (n=32): patients having undergone R3,4 sympathicotomy which consist of blocking the interganglionic neural fiber on the third and fourth rib. The study parameters were satisfaction rate and degree of compensatory sweating. RESULT: There was no difference on age and sex, family history, combined hyperhidrosis, and mean follow up month between the two groups. Patients expressing satisfaction were 88.0% in group and 56.3% in groups II with statistically significant difference (p=0.02). Moderate to severe compensatory sweating were 52.0% (embrassing 6 patients, disabling 7 patients) in group I and 62.5% (embrassing 5 patients, disabling 15 patients) in groups II with no significance in the statistical analysis.
CONCLUSION
R3, 4, 5 sympathicotomy was an effective means of treating axillary hyperhidrosis because of higher long term satisfaction rate.