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Results for “Hyperhidrosis”

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At least 343 records · Page 19Linked to original sources

PubMed1997

Bilateral thoracoscopy for sympathectomy in the treatment of hyperhidrosis.

Thoracoscopic sympathectomy has been established as the least invasive technique with high success rates for treatment of palmary hyperhidrosis [1,4,5]. In our procedure both sides are treated during the same operation. A bilateral thoracoscopy was performed in 20 patients for incapacitating hyperhidrosis. Immediate complications at operation were minimal. All patients reported satisfaction with the procedure in spite of compensatory sweating. The short hospital stay has significant financial benefits and these are increased if both sides are treated at the same time. This procedure is more aggressive than the single side procedure but the morbidity is not increased.

Adolescent↗

PubMed1994

Hyperhidrosis as the presenting symptom in post-traumatic syringomyelia.

Post-traumatic syringomyelia is now a well known entity and occurs months or years after a spinal cord injury. The presenting symptoms are usually pain, progressive motor weakness, sensory changes, and increased spasticity. Profuse sweating or hyperhidrosis can be a symptom of the post-traumatic syrinx or can occur in autonomic dysreflexia provoked by peripheral stimuli. We present two patients with cervical spine fractures whose presenting symptom of post-traumatic syringomyelia was hyperhidrosis affected by posture. The pathophysiology involved and the management of these patients is discussed.

Adolescent↗

PubMed1999

A randomized, double-blind, placebo-controlled trial of botulinum A toxin for severe axillary hyperhidrosis.

Excessive axillary hyperhidrosis is a socially embarrassing condition which severely reduces quality of life and may result in psychological disturbance. Available treatment strategies do not resolve the problem in all cases. Intracutaneous injections of botulinum A toxin have been shown to be effective in patients with local sweating disorders. We performed a randomized, double-blind, within-group comparison in 13 individuals (nine women and four men) with severe axillary hyperhidrosis resistant to conventional treatment, to study the effect of intracutaneous injections of botulinum toxin on sweating. A total dose of 200 mouse units of botulinum A toxin (Dysport(R)) was injected into six different sites in one axilla, whereas the other was injected with sterile saline. Objective quantification of sweat production was performed using digitized ninhydrin-stained sheets. Three weeks after treatment, the mean difference in ninhydrin staining between botulinum-treated and placebo-treated axillae was -34.5% (P < 0.001), after 8 weeks -36.9% (P < 0.001) and after 13 weeks -28.4% (P < 0.001). Subjective rating of sweat production was evaluated on a visual analogue scale (0, no sweating, to 100, most severe sweating). Three weeks after treatment the difference between the botulinum-treated and placebo-treated axillae was -56.5% (P < 0.001), after 8 weeks -67.4% (P < 0.001) and after 13 weeks -62.5% (P < 0.001). No serious side-effects were observed.

Adult↗

PubMed2001

Side-effects of intradermal injections of botulinum A toxin in the treatment of palmar hyperhidrosis: a neurophysiological study.

Focal palmar hyperhidrosis can be effectively abolished by intradermal injections with botulinum toxin. Muscle weakness of finger grip has been reported as a reversible side-effect of this new treatment. The objective of this work was to measure muscular side-effects after treatment of palmar hyperhidrosis with botulinum toxin. As botulinum toxin has been used in the treatment of pain, we studied whether the toxin might influence afferent thin-fibre function by measuring temperature perception thresholds. Thirty-seven patients treated with botulinum toxin (Botox, Allergan Pharmaceuticals, Irvine, CA, USA) showed a decrease in compound muscle action potential (CMAP) for both abductor pollicis brevis (APB) and abductor digiti minimi (ADM) compared with pre-injection values on average by 64 and 36%, respectively, at 3 weeks which returned nearly to normal at 37 weeks. Muscle power for both finger abduction and finger opposition decreased to a lesser extent. Repetitive nerve stimulation and single fibre electromyography (EMG) showed a disturbed neuromuscular transmission. Thus, despite careful technique with small doses of botulinum toxin injected intradermally, the toxin diffuses to underlying muscles. With regard to the present results, one should be careful in using higher doses of Botox than 0.8 mU/cm(2) in the palmar skin above intrinsic muscles. No influence on thin-fibre function was seen.

Action Potentials↗

PubMed2000

Treatment of axillary hyperhidrosis: combination of the starch-iodine test with the tumescent liposuction technique.

OBJECTIVE: To evaluate and permanently improve axillary hyperhidrosis. BACKGROUND: Excessive sweating of the axillae is a common problem for which patients frequently seek dermatologic advice and therapy. Many treatments, including aluminum chloride, topical and systemic anticholinergic agents, tranquilizers, iontophoresis, direct surgical excision, botulinum toxin injection, and thoracic sympathectomy, have been employed to control this problem. All have drawbacks of one sort or another. METHODS: The starch-iodine technique for delineation of preoperative and postoperative axillary sweating is described in detail. A method of sweat gland removal utilizing tumescent liposuction is discussed. RESULTS AND CONCLUSION: The combination of the starch-iodine technique and tumescent liposuction is safe and effective for therapy of axillary hyperhidrosis.

Axilla↗

PubMed2002

Gravimetrically controlled efficacy of subcorial curettage: a prospective study for treatment of axillary hyperhidrosis.

BACKGROUND: Botulinum toxin A (BTX-A) proved to be effective for the treatment of axillary hyperhidrosis by means of gravimetry. Quantitatively controlled studies for surgical treatment are lacking so far. OBJECTIVE: To prospectively test the efficacy of subcorial axillary curettage by gravimetric evaluation of pre- and postsurgical sweat rates. METHODS: Conservatively pretreated patients received subcorial curettage under tumescent local anesthesia using a sharp spoon. Sweat rates of each axilla were determined gravimetrically before and 4-8 weeks after surgery. Evaluation was performed with respect to baseline sweat rates greater than 50 mg/min (group A), greater than 25 and less than 50 mg/min (group B), and less than 25 mg/min (group C). Side effects and patients' ratings were also recorded. RESULTS: Of 42 treated patients, 38 could be evaluated completely. In 29 axillae of group A (high sweat rates), an average reduction from the baseline of 85.6 mg/min to 21.6 mg/min could be achieved (P <.0001). Corresponding values for 22 axillae of group B (medium sweat rates) were 36.8 mg/min and 16.5 mg/min (P <.0001). In 25 axillae with low sweat rates (group C), a significant reduction in sweat rates could not be achieved. The results remained almost stable during a median follow-up of 11 months (range 4-24 months). Only minor side effects were observed and patient satisfaction was high in groups A and B. CONCLUSION: Subcorial curettage is an effective treatment of axillary hyperhidrosis for patients with baseline sweat rates greater than 25 mg/min.

Adult↗

PubMedDate not supplied

Idiopathic localized unilateral hyperhidrosis in a child.

Idiopathic unilateral circumscribed hyperhidrosis is an extremely rare form of increased sweat production that occurs within a sharply demarcated area on the face or upper extremities of otherwise healthy patients. There are no associated neurovascular or metabolic abnormalities. We report idiopathic localized unilateral hyperhidrosis on the upper extremity of a healthy 4-year-old girl.

Child, Preschool↗

PubMed2001

Endoscopic extraperitoneal lumbar sympathectomy for plantar hyperhidrosis: case report.

A right sided endoscopic retroperitoneal lumbar sympathectomy was performed on a 23 year old female who had plantar hyperhidrosis. After the operation, the right foot temperature increased and the plantar hyperhidrosis was relieved. During the follow up period, both feet were warm and dry, although only the right side lumbar sympathectomy had been performed. The outcome appeared to be compatible with that of an open procedure but with minimal invasiveness.

Adult↗

PubMed2001

Thoracoscopic sympathectomy for palmar hyperhidrosis: effects on pulmonary function.

Palmar hyperhidrosis, probably caused by an over-reactivity of sympathetic nerves passing through the second and the third thoracic sympathetic ganglia (T2 & T3 ganglia), can only be cured by sympathectomy. Such sympathetic denervation may also alter pulmonary function. Previous studies have shown that open sympathectomy can cause significant deterioration in pulmonary function, however, the surgical procedure itself may contribute to the change. Recently thoracoscopic sympathectomy has been developed as a minimally invasive but effective treatment for palmar hyperhidrosis. In order to investigate the effect of sympathectomy, pulmonary function was compared before and four weeks after operation in 20 patients. Forced vital capacity (FVC) (-2.3%), forced expiratory volume in one second (FEV1) (-6.1%), and FEV1/FVC (-4.6%) were all slightly but significantly decreased four weeks after thoracoscopic sympathectomy. Also the instantaneous forced expiratory flow at 75%, 50% and 25% of the FVC (Vmax25, Vmax50, Vmax75) in flow-volume curves were decreased (-1.6%, -8.4%, and -20% respectively). Therefore, thoracoscopic sympathectomy minimises pulmonary restrictive effects but allows subclinical small airway obstructive effects to become more evident.

Adolescent↗

PubMed1998

Thoracoscopic upper thoracic sympathectomy for primary palmar hyperhidrosis--the combined paediatric, adolescents and adult experience.

OBJECTIVE: To present our experience, over the past 4 years, of thoracoscopic upper thoracic sympathectomy in patients with primary palmar hyperhidrosis. DESIGN: Retrospective study. SETTING: University hospital, Israel. SUBJECTS: 402 thoracoscopic upper thoracic sympathectomies in 223 patients over a period of 4 years. INTERVENTIONS: Thoracoscopic ablation of ganglia and severing of the sympathetic chain at the level of T2 and T3. 142 patients underwent bilateral simultaneous sympathectomy, 37 had bilateral non-simultaneous sympathectomy and 44 had unilateral sympathectomy. RESULTS: 220 patients (98.7%) had an uneventful postoperative course and were discharged the following day. Three patients with residual pneumothorax required intercostal drainage and were discharged on the third postoperative day. 219 patients (98.2%) were completely satisfied, having immediate and permanent relief of palmar sweating. Four patients were dissatisfied. CONCLUSION: The thoracoscopic approach to the upper thoracic sympathectomy is at present the procedure of choice. Early operation for severe palmar hyperhidrosis is indicated to save a child many years of frustration and discomfort.

Adolescent↗

PubMed1999

Transthoracic endoscopic sympathectomy for palmar hyperhidrosis in children and adolescents: analysis of 350 cases.

Primary palmar hyperhidrosis (PH) often commences in childhood and adolescence and can be a disabling condition. There are few reports regarding endoscopic sympathectomy for PH in children and adolescents. Therefore, I present our experience with transthoracic endoscopic sympathectomy (TES) in treating PH in children and adolescents. From July 1994 to March 1998, a total of 350 patients underwent TES. There were 93 males and 257 females with a mean age of 12.9 years (range 5-17 years). All patients were placed in a half-sitting position under single-lumen intubated anesthesia. We performed ablation of the T2 ganglion using either a 6- or an 8-mm 0 degree thoracoscope (Karl Storz Company, Germany) via one 0.8-cm incision just below each axilla. Among these 350 patients, 699 sympathectomies were performed. Usually, TES was accomplished within 15 minutes (range 7-20 minutes). The surgical complications were minimal: one pneumothorax and one segmental lung collapse. There were no surgical deaths. With a mean postoperative follow-up period of 25 months (range 5-44 months), the result of TES was highly satisfactory in 331 patients (94.6%), although 301 patients (86%) developed compensatory sweating of the trunk and lower limbs, the distribution being the axillae (12%), back (86%), abdomen (48%), or lower limbs (78%). The recurrence rates of palmar hyperhidrosis were 0.6% in the first year, 1.1% in the second year, and 1.7% in the third year. Transthoracic endoscopic sympathectomy is a safe and effective method for treating PH in children and adolescents.

Adolescent↗

PubMed1992

Anaesthesia for transthoracic endoscopic sympathectomy in the treatment of upper limb hyperhidrosis.

Renewed interest has been shown in transthoracic endoscopic sympathectomy (TES) for the treatment of upper limb hyperhidrosis. We review our experience and discuss the anaesthetic technique and perioperative problems encountered in 58 patients undergoing TES for hyperhidrosis. Patients were monitored for arterial pressure, heart rate, ECG, pulse oximetry (SpO2), end-tidal carbon dioxide concentration, peak inspired airway pressure and skin temperature. General anaesthesia, with a double-lumen endobronchial tube, enabled the lungs to be collapsed alternately, thereby ensuring easy and clear access to the sympathetic chain. Controlled ventilation with 100% inspired oxygen was necessary to obviate hypoxaemia. In two patients, severe hypotension and bradycardia occurred during insufflation of carbon dioxide into the chest cavity. Four patients required underwater drainage of the pleural cavity for treatment of pneumothorax or haemothorax. The success and safety of the procedure depends on a scrupulous anaesthetic technique.

Adolescent↗

PubMed1989

Prophylactic antibiotics in surgical treatment of axillary hyperhidrosis.

A randomized, prospective, double-blind study designed to compare the effectiveness of the use of cloxacillin with the result of nontreatment in patients undergoing surgical intervention of axillary hyperhidrosis was conducted from August 1987 to October 1987 at the Veterans General Hospital, Taipei, Taiwan. Forty-two patients were enrolled in this study. Fifty wounds (25 patients) were control subjects, and 34 wounds (17 patients) received cloxacillin. The positive bacterial culture rates of the tissues and draining from patients in the treatment group compared with the control group was statistically significantly lower (p less than 0.01). No significant differences presented in relation to age, sex, complication rate, fever index, and length of hospital stay. Prophylactic antibiotic is of no value in elective surgical intervention of axillary hyperhidrosis.

Adolescent↗

PubMed1992

Endoscopic transthoracic sympathectomy in the treatment of hyperhidrosis.

A 5-year experience of 50 endoscopic transaxillary dorsal sympathectomies is presented. The procedure was successful in either curing or improving the symptoms of hyperhidrosis in the great majority of patients. The commonest side effects were compensatory sweating (75%) and gustatory sweating (48%); despite this, there was an extremely high level of patient satisfaction. Permanent Horner's syndrome did not occur. The procedure is effective, simple, cheap, and requires only an overnight stay; and is recommended as the method of choice for the surgical treatment of upper limb hyperhidrosis.

Adolescent↗

PubMedDate not supplied

Review of the use of botulinum toxin for hyperhidrosis and cosmetic purposes.

This article reviews the current status of dermatological uses for botulinum toxin type A (Botox), recently approved in the United States for treatment of glabellar wrinkles, and type B (Myobloc), approved for cervical dystonia. The respective formulations of Botox and Myobloc are described, and injection techniques and special considerations for administration in the treatment of dermatologic conditions are also discussed. The use of botulinum toxin injections for cosmetic treatment of movement-related facial lines and platysmal bands in the neck is reviewed, including injection procedures, efficacy, and potential complications. Recent developments in the use of botulinum toxins for the treatment of palmar and axillary hyperhidrosis are also described, comparing type A and type B results. Although direct comparisons between botulinum toxins for dermatologic applications are complicated by the lack of functional equivalence of the standard potency assays, appropriate dosing strategies for obtaining satisfactory clinical results using type B are being established, which will add to the experience already gained with type A. The diffusion characteristics of type B appear to show different and potentially advantageous clinical profiles in the treatment of crows' feet and hyperhidrosis compared with type A.

Botulinum Toxins↗

PubMed2003

Palmar hyperhidrosis: intraoperative monitoring with laser Doppler blood flow as a guide for success after endoscopic thoracic sympathectomy.

OBJECTIVE: Video-assisted endoscopic thoracic sympathectomy is an effective surgical procedure for treating patients with palmar hyperhidrosis. An increase by more than 1 degrees C in palmar temperature has been observed to be predictive of good outcome. In this study, we investigated the use of palmar laser Doppler flowmetry as an intraoperative assessment of the efficacy of the operation. METHODS: One hundred sixty-six patients underwent a total of 330 endoscopic thoracic sympathectomy procedures from March 1996 to June 2001. We studied 17 patients (15 men, 2 women) who underwent a total of 33 procedures. The patients' mean age was 27.07 +/- 7.92 years, and the mean hospital stay was 2.23 +/- 0.66 days. RESULTS: Mean baseline laser Doppler blood flow was 2.63 +/- 2.56 ml/min/100 g. After the procedure, mean blood flow increased significantly to 7.24 +/- 5.88 ml/min/100 g (r = 0.768, P < 0.000, 95% confidence limit, -6.1060, -3.0946), a 232.18 +/- 219.12% increase. Mean palmar temperature increased to 1.44 +/- 1.44 degrees C. All patients experienced relief after the operation. Compensatory hyperhidrosis occurred in 10 (58.8%) of 17 patients. CONCLUSION: Monitoring of palmar laser Doppler blood flow changes is a useful adjunct during endoscopic thoracic sympathectomy surgery, and, when coupled with the established methods of endoscopic visualization and palmar temperature, it can predict the success of the procedure accurately.

Adolescent↗

PubMed1978

Radical operation to stop axillary odor and hyperhidrosis.

We have developed a subcutaneous tissue shaver for the radical treatment of hircismus and hyperhidrosis. With this shaver the sweat glands can be removed from the undersurface of the axillary skin through a small incision. We report 3,000 cases of hircismus and hyperhidrosis treated by our method. The postoperative scar has been minimal, healing has been quick, and good results were achieved by this method.

Axilla↗

PubMed2002

Hyperhidrosis: a review of current management.

Primary hyperhidrosis is a troublesome disorder of excessive perspiration that affects as much as 1 percent of the population. Sufferers are usually young and are often affected by related social, professional, and psychological problems. Many methods for treating hyperhidrosis exist; however, no single treatment is without its weakness or complications. This article aims to clarify the issues related to the use of each treatment modality, including the most recently proposed method using botulinum toxin.

Axilla↗