Abstract
Introduction: Hyperhidrosis is distressing and a source of intense embarrassment. Numerous methods of sympathectomy, including open thoracotomy, as well as posterior and supraclavicular approaches have been performed. Endoscopic thoracic sympathectomy (ETS) is a new approach for hyperhidrosis patients. However, it is still unclear about changes in sympathetic nerve function after ETS.
Methods: 38 subjects with hyperhidrosis were enrolled in this study. Assessments of sympathetic skin response (SSR) and thermography were performed to evaluate sympathetic nerve activity before and 1, 3, 6 and 12 months after ETS. Total amount of sweat and core temperature of a hand were also measured. Thermatome was made by thermography to investigate the range of upper thoracic sympathetic nerve innervation.
Results: Results showed 76 hands became dry and SSR disappeared in all subjects just after the operation. Four of 38 subjects showed recurrence of sweat within 12 months of recovery. In these 4 subjects, SSR appeared before sweat reappeared in their palms again.
Thermography showed that the sin temperature of face, upper limbs, upper trunk, and bilateral palms was significantly increased. Nine thermatomes were classified by thermography. Most patients showed compensatory hyperhidrosis.
Conclusion: These results suggest that SSR is a valuable method to assess the sympathetic function after ETS and could be a parameter for anticipating prognosis. The upper thoracic sympathetic nerve may innervate a wide area, such as face, upper limb and upper trunk.
