Sympathetic Ablation for Primary Palmar Hyperhidrosis: Could Controversies be solved?

Abstract

Excessive perspiration of the palms of unknown etiology is present in a substantial number of the young people. It may cause severe social, emotional and occupational handicaps. A multitude of therapies exist, but sympathetic ablation is the only method that may obtain permanent relief. Sympathectomy, however, is not devoid of consequences, compensatory hyperhidrosis (increase in perspiration in areas of the body unaffected by the sympathetic ablation) is the most important and may attain devastating proportions. With the advent of thoracoscopic surgery, several modifications of the standard T2-T3 ablation were introduced. It was postulated that lowering the level of ablation and reducing its extent would attenuate the amount of compensatory hyperhidrosis