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Selective division of T3 rami communicantes (T3 ramicotomy) in the treatment of palmar hyperhidrosis

 Doo Yun Lee  ;  Do Hyung Kim  ;  Hyo Chae Paik 
 ANNALS OF THORACIC SURGERY, Vol.78(3) : 1052-1055, 2004 
Journal Title
Issue Date
Adult ; Female ; Hand/innervation ; Hand/surgery ; Humans ; Hyperhidrosis/surgery* ; Male ; Patient Satisfaction ; Recurrence ; Reoperation ; Sympathetic Nervous System/surgery*
BACKGROUND: Compensatory sweating (CS) is the main cause of a patient's dissatisfaction after sympathetic surgery for palmar hyperhidrosis. Preservation of the sympathetic nerve trunk and limitations on the range of dissection are necessary to reduce CS. METHODS: We compared 64 patients (31 male, 33 female) (group 1) who underwent a T2 sympathicotomy between July 1998 and February 1999 and 83 patients (58 male, 25 female) (group 2) who underwent a T3 ramicotomy between August 2000 and December 2002. RESULTS: In group 1, 60 patients (93.8%) exhibited a decreased sweating on both hands, but 4 patients (6.2%) exhibited a persistent sweating on both hands. For group 2, 58 patients (69.9%) experienced a decreased sweating on both hands, 15 patients (18.1%) experienced a persistent sweating on both hands, and 10 patients (12.0%) experienced a persistent sweating on one hand. The grade of CS in group 2 was significantly lower than in group 1 (p < 0.001) and, notably, the rate of embarrassing and disabling CS in group 2 (15.5% [9 out of 58]) was significantly lower than in group 1 (43.3% [26 out of 60], p value < 0.001). The rate of satisfaction was 78.1% (50 out of 64) for group 1 and 68.6% (57 out of 83) for group 2 with no significant statistical difference indicated (p = 0.202). CONCLUSIONS: The incidence of sweating postoperatively was relatively high in the T3 ramicotomy group, although the T3 surgery did result in a lower incidence of CS when compared with a T2 sympathicotomy.
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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)
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