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Comparative analysis of T2 selective division of rami-communicantes (ramicotomy) with T2 sympathetic clipping in the treatment of craniofacial hyperhidrosis

Authors
 Do Hyung Kim  ;  Hyo Chae Paik  ;  Doo Yun Lee 
Citation
 EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, Vol.26(2) : 396-400, 2004 
Journal Title
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
ISSN
 1010-7940 
Issue Date
2004
MeSH
Adult ; Autonomic Nerve Block/methods ; Face ; Female ; Head ; Humans ; Hyperhidrosis/physiopathology ; Hyperhidrosis/surgery* ; Male ; Patient Satisfaction ; Retrospective Studies ; Sweating/physiology* ; Sympathectomy/methods ; Sympathetic Nervous System/physiopathology ; Sympathetic Nervous System/surgery* ; Thoracic Surgical Procedures/methods ; Treatment Outcome
Keywords
Hyperhidrosis ; Sympathetic surgery ; Rami-communicantes
Abstract
OBJECTIVE:
The main cause of dissatisfaction after sympathetic trunk blocking surgery (T2 sympathectomy, sympathetic clipping) for craniofacial hyperhidrosis is compensatory sweating. Preserving sympathetic trunk may decrease the incidence of compensatory sweating, and we introduce T2 ramicotomy, which may better preserve the sympathetic nerve trunk in order to reduce compensatory sweating.
METHODS:
From January 2000 to November 2002, video-assisted thoracoscopic (VAT) T2 sympathetic clipping and VAT ramicotomy were performed in 44 patients suffering from craniofacial hyperhidrosis. Twenty-two patients underwent T2 sympathetic clipping (group 1), and 22 underwent division of T2 rami-communicantes (group 2). We retrospectively analyzed the rate of satisfaction, dryness of face, and grade of compensatory sweating.
RESULTS:
Both groups were similar with respect to facial dryness (P = 0.099). Group 1: excessive dry 5 patients (22.7%), dry 17 patients (77.3%); group 2: excessive dry 3 patients (13.6%), dry 15 patients (68.1%), and persistent sweating 4 patients (18.3%). The rate of satisfaction was 77.3% in group 1, and 63.6% in group 2 with no significant difference (P > 0.05). The rate of compensatory sweating in group 2 (72.7%) was significantly lower than in group 1 (95.4%) (P < 0.039). The chance of embarrassing and disabling compensatory sweating was lower in group 2 than in group 1; 76.5% (embarrassing in 8 patients, disabling in 9) in group 1, and 36.4% (embarrassing in 7 patients, disabling in 1) in group 2 which was statistically significant (P < 0.006).
CONCLUSIONS:
T2 ramicotomy for craniofacial hyperhidrosis lowers the rate of compensatory sweating and excessive dryness of face compared to T2 clipping.
Full Text
http://ejcts.oxfordjournals.org/content/26/2/396.long
DOI
10.1016/j.ejcts.2004.04.030
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Lee, Doo Yun(이두연)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/111177
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