Hyperhidrosis is excessive sweating. For most people, sweating is a protective measure against overheating and a reaction to physical or emotional stress. However, in some people, sweat glands in the palms, armpits and face receive random signals from the sympathetic nervous system. These impulses are not associated with the physiological needs of the body and appear spontaneously. Due to wet palms, patients begin to avoid communication, try to avoid shaking hands, they have difficulties when working with small objects or papers, and psychological problems appear.
There are conservative treatments for hyperhidrosis, but they do not give lasting improvement or are accompanied by a large number of side effects: antiperspirants work for several hours, the effect of Botox injections is short-lived, intake of sedatives makes drowsiness and interferes with driving.
The surgery for sweaty palms consists in removing those parts of the thoracic sympathetic trunk and its branches that are responsible for perspiration on the upper limbs and face. This operation is called thoracic sympathectomy (ETS surgery). Immediately during the operation, the palms become not only dry but also warm since the signals for vasoconstriction cease. This property of sympathectomy allows it to be used to treat pathological vasospasm of the hand – Raynaud’s syndrome.
Thoracoscopic sympathectomy is performed under general anesthesia through small punctures in the chest. Using a miniature video camera and special instruments, the surgeon finds the sympathetic trunk on the spine and crosses the fibers responsible for transmitting impulses to the problematic part of the body (hands, armpits, face). The operation on both sides takes less than an hour. In case of an uncomplicated course, the patient can go home the next day after the operation.
Palmar hyperhidrosis surgery (ETS surgery) cost is about $10,000.
The main side effect of such operations is compensatory hyperhidrosis – increased sweating in other areas of the body. Most often, sweating on the front of the thighs and abdomen may increase. The extent of this compensatory sweating is usually mild and usually resolves within a few weeks, however, the patient should be aware of the problem.
Other complications, in particular Horner’s syndrome, may occur when a surgeon is not experienced. This happens if the upper part of the sympathetic nerve, the stellate ganglion, is damaged during surgery. At the same time, it can cause a drooping eyelid, constriction of the pupil and eye dryness on the damaged side. Therefore, surgical treatment of hyperhidrosis should be carried out only by experienced surgeons.
Tags: excessive sweating, palmar hyperhidrosis, sweating, sweaty palms
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