| Hyperhidrosis |
| A
New
hyperhidrosis CD is available
through our office. The CD outlines the experience of
suffering from excessively sweaty hands from a patients point
of view and scenes from the operation itself. Contact Glory
Hammond for copies... |
 |
Hyperhidrosis
is an unusual condition which results in excessive sweating
of the hands and feet. At times the face may be involved. This
problem is socially embarrassing and presents functional problems
for the sufferer as well. Excessive facial blushing can occur
in some individuals. |
| Although
excessive sweating can result from certain chronic diseases
such as diabetes, tuberculosis, and polyneuropathy, in the vast
majority of individuals there is no known cause. The incidence
is probably greater in Orientals and rarely, the disorder is
familial. |
| In
our experience, the impact of HH on the lives of patients is
greatly underestimated by the medical community. Unfortunately,
the ease and effectiveness of surgery is also largely
unappreciated. The medical treatments for hyperhidrosis include:
psychotropic medications,
anti-cholinergic medications,
tap water iontophoresis, and aluminum chloride preparations (DrySol).These
measures fail in the most refractory cases. |
| |
 A
simple, surgical
procedure is available which permanently ends sweating in the
hands: endoscopic thoracic sympathectomy (ETS). Interruption
of the sympathetic nerves in the upper chest cavity stops hand
sweating and reduces sweating in the face in the vast majority of
patients. Pathological blushing
responds as well.
|
Leriche
first described interruption of the sympathetic nerves to treat
HH in 1934 and endoscopic techniques were initially developed
by Kux and reported in 1954. Our experience with ETS began in
1990. Sympathectomy does not cause loss of sensation or weakness.
|
The
surgeon introduces a small endoscope through a 1/2 inch incision
under each arm. The appropriate nerve ganglion is coagulated
and the patient returns home after a few hours' stay. . .
usually the same day as surgery. |
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|
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Virtually
all patients immediately develop warm, dry hands and leave the
hospital the same day as surgery. Complications are rare. Recurrence
of sweating is less than 2 %. Infections and other complications
are very unusual. Horner's syndrome, (drooping of the eye lid and
a small pupil size) does not occur after interruption of the
T2 or T3 ganglia. About 1/3 of individuals develop excessive
sweating on the lower chest or abdominal wall, so-called compensatory
hyperhydrosis. For most this is well tolerated and accepted
in lieu of sweaty hands.
Click
here to see Tally Johnson's experience.
|
