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  • Palmar Hyperhidrosis with failed Medical Management, a Case Discussion

    by Fritz J. Baumgartner, MD

    A 17 year old nursing student presents with massive, dripping palmar hyperhidrosis which is quite debilitating for her in her studies, future career goals, and day to day personal interactions. She has tried and failed topical aluminum chloride, ionotophoresis, oral anticholinergic agents, and Botulinum toxin injections. What is the current evidence to support the benefit of thoracoscopic sympathectomy as opposed to the risk? What level should be included – T2? T3? T4? All of the above? Does sympathicotomy or ramicotomy give better results than a formal sympathectomy? Is clipping rather than transaction warranted for anticipated reversal? Does including T2 increase the risk of compensatory sweating? Does omitting T2 increase the risk of surgical failure?

    Posted on Tuesday, October 21st, 2008 at 4:05 pm
    Category: Hyperhidrosis
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