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To avoid compensatory hyperhidrosis after sympathetic surgery for craniofacial hyperhidrosis

 Duk Hwan Moon  ;  Du-Young Kang  ;  Hye Sun Lee  ;  Ji-Won Lee  ;  Yong-Jae Lee  ;  Sungsoo Lee 
 JOURNAL OF THORACIC DISEASE, Vol.12(5) : 2529-2535, 2020-05 
Journal Title
Issue Date
Craniofacial hyperhidrosis (CFH) ; compensatory hyperhidrosis (CS) ; endoscopic thoracic sympathectomy (ETS) ; heart rate variability test (HRV)
Background: Endoscopic thoracic sympathectomy (ETS) has not been widely adopted for treating craniofacial hyperhidrosis (CFH) due to its known postoperative complication, compensatory hyperhidrosis (CH). In this study, we evaluated whether the autonomic nerve analysis data via pre-ETS heart rate variability (HRV) test can predict post-ETS CH in patients with CFH. Methods: From October 2017 to March 2019, we consecutively included CFH patients who underwent ETS and received preoperative HRV. In this prospective observational study, we evaluated those who developed CH 3 months postoperatively. The CH grades were categorized into none, mild, moderate, and severe. Results: A total of 53 patients were included; the mean age was 42.5±13.2 years, and there were 41 males (77.4%). Twenty-six (49.1%) patients had a post-ETS CH grade of greater than moderate (moderate and severe). We further classified the group into trivial and serious compensation, based on the CH grade for comparison. Among the various HRV values, low frequency/high frequency (LF/HF) value was the only one that achieved statistical significance (P=0.025). Moreover, among those in the trivial compensatory group, 23 (85.2%) patients had an LF/HF value between 0.66 and 2.60, and therefore, were included in the autonomic balanced group. On the other hand, among those in the serious compensatory group, 24 patients (92.3%) had an LF/HF value of less than 0.66 and greater than 2.60, and thus, in the autonomic dysfunction group. Conclusions: According to the present study, HRV test, especially the HF/LF value, appears to be a useful test in predicting post-ETS serious CH.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Family Medicine (가정의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Moon, Duk Hwan(문덕환)
Lee, Sung Soo(이성수) ORCID logo https://orcid.org/0000-0001-8998-9510
Lee, Yong Jae(이용제) ORCID logo https://orcid.org/0000-0002-6697-476X
Lee, Ji Won(이지원) ORCID logo https://orcid.org/0000-0002-2666-4249
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
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