Computed tomography guided thoracic sympatholysis for palmar hyperhidrosis.
METHODS: Sixteen patients (mean age 26.3 years; range 18-38) with palmar hyperhidrosis underwent 29 sympatholyses after unsuccessful medical, and in 8 ionophoresis, treatments. Sympatholysis was performed under local anesthesia with computed tomographic guidance. After opacification of the injection site at T3 with Iopamiron 200, phenolization was performed with 10 ml 6% phenol. RESULTS: Good immediate results evaluated on the basis of venous dilatation, and dryness and warmth of the skin were obtained in 23 cases (80%). There were 6 immediately unsuccessful procedures in 4 patients. At 20 months, good results, assessed on the basis of objective criteria and subjective patient self-evaluation were obtained in 22 cases (75% including immediate failures). Computed tomography guided thoracic sympatholysis performed under local anesthesia is an effective treatment for palmar hyperhidrosis. Morbidity is low and hospital stay is short. CONCLUSIONS: Our findings suggest that thoracic sympatholysis should be indicated as the first intention procedure when surgery is required in patients with palmar hyperhidrosis.