Uncategorized
Sympathectomy Hyperhidrosis
Hyperhidrosis is a medical condition characterized by excessive sweating. Excessive sweating can occur in the hands (palmar hyperhidrosis), underarms (axillary hyperhidrosis), feet (plantar hyperhidrosis) or face (facial hyperhidrosis). Although its exact cause is still unknown, most medical professionals believe that it is caused by the hyperactivity of the sympathetic nerve chains. The sympathetic nervous system is responsible for involuntary bodily functions and one of which, is the production of sweat, which is essential in regulating body temperature.
Hyperhidrosis is often a distressing, socially debilitating condition, affecting a small but significant proportion of the world population. While symptoms usually begin during adolescence, it can also occur in other age groups.
Treatment options given to patients who suffer from hyperhidrosis usually depend on the severity of their case and which body area is affected. Non-surgical treatments such as oral medications, anti-perspirants, ointments, botox injections and iontophoresis, are the usual initial options given to patients. When none of those treatments prove beneficial or effective, there are also surgical treatments available to patients seeking more permanent results.
In the past, surgical procedures done for hyperhidrosis cases usually involve a painful incision either at the chest, back or neck (e.g. upper thoracic sympathectomy). Most often than not, these highly invasive procedures result to complications such as brachial plexus, phrenic nerve injury, or Horner’s Syndrome, a condition that can cause dropping of the upper eyelids and eye dryness. In rare cases, excessive bleeding may likewise happen. Due to recent technological advances, minimally invasive surgical methods, such as thoracoscopic sympathectomy or otherwise known as endoscopic thoracic sympathectomy (ETS), were made possible.
ETS is a surgical procedure that intends to interrupt sympathetic nerve impulses sent to the sweat glands and prevent localized excessive sweating (usually in the hands and face). While the patient is under general anesthesia, a 5-mm. endoscope is inserted into a small incision made below the underarm to identify the second through fourth ganglia. The identified branches to the main sympathetic chain at each level are divided before the main chain is removed. The same procedure is done on the patient’s other side, which is crucial in preventing symptoms from recurring years later.
ETS is most effective in treating excessive hand and facial sweating, with a success rate of more than 98%. It also gives additional relief to excessive feet sweating. While it is a highly effective procedure with permanent results, it has very minimal complication rate. Incident of Horner’s Syndrome for instance, is about less than 1%.
As with most surgical procedures, ETS also has some side effects and the most common of which is compensatory sweating. Compensatory sweating occurs in about 50% of ETS patients. Also, there are reported cases of small pneumothorax after the operation, but in this case, no medical intervention is required and patients can usually go home after 24 hours.
While ETS is generally safe and a highly effective method in treating hyperhidrosis cases, it is still best for patients to look only for experienced, highly competent and certified surgeons for excellent and long-term results.
Hyperhidrosis Hands
Severe perspiration of the hands can take place on its own or in combination with extreme perspiration of the underarms, face and scalp, or feet. Facial blushing may also be experienced when sweaty hand disorder is present. The most common incidence in hyperhidrosis is the combination of extreme hand and feet sweating.
The condition of hyperhidrosis is caused by the over-stimulation of the sweat glands by the sympathetic nervous system. Hand perspiration can be extreme. A lot of individuals perspire so severely that dripping sweat can actually be seen on the floor. These can be observed even in the most frigid of conditions. A few individuals may not experience dripping sweat, but their hands are typically cold, discolored and clammy. Newspaper print easily mark their hands. Book pages tend to have curled edges due to the constant wetness of their hands.
Before the start of excessive perspiration, several individuals claim to have a tingling sensation on their fingers. One individual claimed, “it seems as if my skin pores are opening up.” The phenomenon is unintentional and cannot be deliberately controlled. There is an unusual interrelationship that develops between anxiety and severe perspiration. The relationship develops variably to a greater or lesser degree in most individuals with extreme hyperhidrosis disorder. The condition is frequently worsened by anxiety. The onset of symptoms usually provokes anxiety to the sufferer. A vicious cycle is unfortunately created due to this. Countless sufferers struggle to get away by pulling out of or staying away from stressful situations. This repetitive pattern is unhealthy and it only serves to create more emotional injury to the person.
People with hyperhidrosis would normally try to hide their hands when having conversations with other people. They may do one or any of the following things like placing their hands under their arms, putting their hands behind their backs or simply place them under their thighs. Numerous individuals with hyperhidrosis of the hands have reported that holding a cold drink in their hands during social occasions makes shaking other people’s hands socially acceptable. This is because people would tend to assume that the hand they just shook was cold, wet and clammy due to the cold glass.
One reported case about a young woman professional with hyperhidrosis of the hands mentioned that, before a job interview, she would rub her hands on her car’s tire. She would then tell the interviewer that she had had a flat tire and she shouldn’t shake his hand because her hands were filthy. This is a very unfortunate example of how people suffering from this condition try to adapt. This is primarily because people who are not familiar with this particular disorder has the tendency of looking down at the person with the condition.
Fortunately, with the latest advances in modern medicine, many forms of treatment are now available for palmar hyperhidrosis. Antiperspirants are the first choice in the treatment of hyperhidrosis. Iontophoresis home kits are now available for patient use but the equipment that hospitals use is still stronger and more reliable. Botox on the other hand works well but it is quite expensive and the relief it offers only last from 6 to 12 months. Low dosage medication and surgical operations are also utilized to cure severe hyperhidrosis. Endoscopic thoracic sympathectomy or ETS can be a very effective technique to treat hyperhidrosis. However, great care must be taken in choosing a surgeon. This is due to the risk of side effects from compensatory sweating. The patient should consider everything carefully before deciding to undergo this procedure.


