The Institute of Chest Wall Surgery
Hyperhidrosis
Introduction
Hyperhidrosis is a benign condition characterized by episodic sweating of the hands, leading to noticeable sweat beads or droplets. It is commonly seen in adolescents and young adults, typically starting between the ages of 8 and 12. Symptoms are most pronounced before the age of 30, and tend to gradually lessen after 40. However, a small percentage of patients may experience symptoms throughout their lifetime.
Causes
The exact cause of primary hyperhidrosis remains unclear, but it is thought to be related to genetic factors or sympathetic nervous system dysfunction. Secondary palmar hyperhidrosis is often caused by neurological, endocrine, or other systemic diseases, such as anxiety disorders, hyperthyroidism, tuberculosis, and diabetes.
Symptoms
Hyperhidrosis typically manifests as excessive sweating of the palms, ranging from mild moisture to severe dripping sweat. Most patients also experience excessive sweating of the feet, and about 30% suffer from concurrent axillary hyperhidrosis. Some patients may additionally exhibit clamminess, cyanosis, eczema, or desquamation of the palms. These symptoms not only disrupt their daily life but also potentially lead to social difficulties, anxiety and feeling of inferiority.
Diagnostic Methods
A clear diagnosis can often be made through a thorough review of medical history and a physical examination. For patients suspected of having underlying conditions, further tests such as complete blood count, urinalysis, stool analysis, blood biochemistry, thyroid function test, and chest CT scan can be conducted to pinpoint the cause.
Surgical Procedure
T4 sympathectomy:
With the assistance of thoracoscopy, this procedure involves dissecting the sympathetic nerve chain along the surface of the 3rd or 4th rib. It is considered an ideal treatment for hyperhidrosis, achieving effectiveness rates between 95% to 100%. Additionally, after the surgery, the incidence of compensatory sweating in other parts of the body is relatively low, with symptoms typically being mild.
