Purpose. To evaluate the efficacy, safety and middle-term results of upper thoracic sympathetic chain neurolysis performed under CT guidance in patients with palmar/axillary hyperhidrosis. Materials and methods. From April 1999 to July 2000 we performed 30 upper thoracic sympathetic chain neurolysis in 15 patients presenting with palmar/axillary hyperhidrosis (6 M, 9 F, mean age 29.5 years). Neurolysis was performed under CT guidance injecting 2-10 ml of a solution of phenol 8%, glycerine 20% and saline through 22 G needles placed in the paraspinal space at T3 level through a paraspinal extrapleural approach. At least one week was allowed between neurolysis of right and left thoracic sympathetic chain in the same patient. Procedures were performed on outpatient basis. Patients were followed up with interviews and/or physical examination every 6 months for 2 years. Results. All patients experienced immediate cessation of symptoms. Three patients (20%) experienced one-sided recurrence of symptoms 5, 7 and 12 months respectively after the first neurolysis, which disappeared after a repeated procedure. Two (13%) patients showed a slight Horner's syndrome immediately after the procedure, which resolved in 1 and 2 months respectively. Two patients (13%) experienced pain in the arm on the same side of the neurolysis, which resolved in 1 week. Three (20%) patients experienced mild compensatory sweating. All patients declared they were satisfied with the outcome of the neurolysis when interviewed at 2 years follow up from the first procedure, with no recurrence of symptoms. Conclusions. Upper thoracic sympathetic chain neurolysis performed under CT guidance in patients with palmar/axillary hyperhidrosis is a safe procedure, with low rate of complications and good results at 2 years follow-up.

Upper thoracic sympathetic chain neurolysis under CT guidance. A two year follow-up in patients with palmar and axillary hyperhidrosis [Neurolisi percutanea sotto guida TC della catena simpatica toracica superiore. Follow-up a due anni in pazienti con iperidrosi palmare ed ascellare]

Mainenti;Ma
2002

Abstract

Purpose. To evaluate the efficacy, safety and middle-term results of upper thoracic sympathetic chain neurolysis performed under CT guidance in patients with palmar/axillary hyperhidrosis. Materials and methods. From April 1999 to July 2000 we performed 30 upper thoracic sympathetic chain neurolysis in 15 patients presenting with palmar/axillary hyperhidrosis (6 M, 9 F, mean age 29.5 years). Neurolysis was performed under CT guidance injecting 2-10 ml of a solution of phenol 8%, glycerine 20% and saline through 22 G needles placed in the paraspinal space at T3 level through a paraspinal extrapleural approach. At least one week was allowed between neurolysis of right and left thoracic sympathetic chain in the same patient. Procedures were performed on outpatient basis. Patients were followed up with interviews and/or physical examination every 6 months for 2 years. Results. All patients experienced immediate cessation of symptoms. Three patients (20%) experienced one-sided recurrence of symptoms 5, 7 and 12 months respectively after the first neurolysis, which disappeared after a repeated procedure. Two (13%) patients showed a slight Horner's syndrome immediately after the procedure, which resolved in 1 and 2 months respectively. Two patients (13%) experienced pain in the arm on the same side of the neurolysis, which resolved in 1 week. Three (20%) patients experienced mild compensatory sweating. All patients declared they were satisfied with the outcome of the neurolysis when interviewed at 2 years follow up from the first procedure, with no recurrence of symptoms. Conclusions. Upper thoracic sympathetic chain neurolysis performed under CT guidance in patients with palmar/axillary hyperhidrosis is a safe procedure, with low rate of complications and good results at 2 years follow-up.
2002
glycerol
phenol derivative
sodium chloride
adult
article
axilla
clinical article
computer assisted tomography
female
follow up
Horner syndrome
human
hyperhidrosis
male
needle
neurolysis
outpatient
pain
patient satisfaction
physical examination
safety
sweating
sympathetic trunk
thoracic spinal cord
treatment outcome
Adult
Axilla
Female
Follow-Up Studies
Hand
Humans
Hyperhidrosis
Male
Patient Satisfaction
Phenol
Sympathectomy
Chemical
Thorax
Tomography
X-Ray Computed
Treatment Outcome
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.14243/211219
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