Abstract
Background
More than 50% of patients with palmar hyperhidrosis (PAH) also have plantar hyperhidrosis
(PLH). We compared the long-term results of T3 sympathectomy with those of combined
T3+T4 sympathectomy among patients with concurrent PAH and PLH.
Materials and methods
We retrospectively analyzed the records of patients with concurrent PAH and PLH who
underwent T3 alone or T3+T4 sympathectomy from January 1, 2012, to December 31, 2017.
Preoperative and postoperative sweating (hyperhidrosis index) was evaluated through
questionnaires, physical examination, and outpatient follow-up. The relief rates and
hyperhidrosis index were used as outcome measures to compare the efficacy of the two
approaches. Patients’ satisfaction and side effects were also evaluated.
Results
Of the 220 eligible patients, 60 underwent T3 sympathectomy (T3 group), and 160 underwent
T3+T4 sympathectomy (T3+T4 group). Compared with the T3 group, the T3+T4 group showed
higher symptom relief rates both for PAH (98.75% versus 93.33%, P = 0.048) and PLH (65.63% versus 46.67%, P = 0.01), and a greater postoperative decrease in both hyperhidrosis indices. The
rate of severe compensatory hyperhidrosis also increased (10% versus 5%, P = 0.197), although the rates of overall satisfaction were comparable between the
groups. The incidence of postoperative pneumothorax requiring chest tube placement
and postoperative neuralgia was also similar. There were no cases of perioperative
death, secondary operation, wound infection, or Horner syndrome in either group.
Conclusions
Compared with T3 alone, T3+T4 sympathectomy achieved a higher symptom relief rate
and a lower hyperhidrosis index. T3+T4 sympathectomy may be a choice for the treatment
of concurrent PAH and PLH; however, patients need to be informed that this kind of
surgery may increase the risk of compensatory sweating.
Keywords
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Article info
Publication history
Published online: March 07, 2021
Accepted:
November 15,
2020
Received in revised form:
November 3,
2020
Received:
March 25,
2020
Identification
Copyright
© 2020 Published by Elsevier Inc.
