J Korean Med Sci.  2010 Apr;25(4):597-601. 10.3346/jkms.2010.25.4.597.

Sympathetic Nerve Reconstruction for Compensatory Hyperhidrosis after Sympathetic Surgery for Primary Hyperhidrosis

• Haam SJ
• Park SY
• Paik HC
• Lee DY

• KMID: 1792931
• DOI: http://doi.org/10.3346/jkms.2010.25.4.597

Abstract

We performed sympathetic nerve reconstruction using intercostal nerve in patients with severe compensatory hyperhidrosis after sympathetic surgery for primary hyperhidrosis, and analyzed the surgical results. From February 2004 to August 2007, sympathetic nerve reconstruction using intercostal nerve was performed in 19 patients. The subjected patients presented severe compensatory hyperhidrosis after thoracoscopic sympathetic surgery for primary hyperhidrosis. Reconstruction of sympathetic nerve was performed by thoracoscopic surgery except in 1 patient with severe pleural adhesion. The median interval between the initial sympathetic surgery and sympathetic nerve reconstruction was 47.2 (range: 3.5-110.7) months. Compensatory sweating after the reconstruction surgery improved in 9 patients, and 3 out of them had markedly improved symptoms. Sympathetic nerve reconstruction using intercostal nerve may be one of the useful surgical options for severe compensatory hyperhidrosis following sympathetic surgery for primary hyperhidrosis.

Keyword

Hyperhidrosis; Nerve Transfer; Sympathetic Nerve; Thoracoscopy

MeSH Terms

Adult
Female
Humans
Hyperhidrosis/*surgery
Intercostal Nerves/anatomy & histology/surgery
Male
Middle Aged
Patient Satisfaction
Quality of Life
Questionnaires
Reconstructive Surgical Procedures/*methods
Sympathetic Nervous System/anatomy & histology/*surgery
Treatment Outcome
Young Adult

Figure

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  Fig. 1 (A) Illustration of operative field. (B) Magnified view of nerve anastomosis. The distal part of the intercostal nerve (a) was placed between the proximal and distal ends of the exposed sympathetic nerve (b) to contact with the sympathetic nerve and intercostal nerve, and fibrin sealant (c) was applied to the contact surface of the sympathetic and intercostal nerve.

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  Fig. 2 (A) and (B) are infrared thermographic image obtained before sympathetic reconstruction surgery and after postoperative 3 months, respectively. Preoperative and postoperative digital infrared thermographic imaging show the apparent thermal change in chest and back.

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