• The Journal of Internal Korean Medicine
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• v.36 no.3
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• pp.323-334
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• 2015

Objectives This study was designed to analyze the characteristics of craniofacial hyperhidrosis and palmar/plantar hyperhidrosis by nasal endoscopy and body composition test. Methods The study sample consisted of 20 and 22 patients with craniofacial hyperhidrosis and palmar/plantar hyperhidrosis, respectively, who answered questionnaires and underwent nasal endoscopy and body composition test. The questionnaires estimated the quality of life by Dermatology Life Quality Index score (DLQI), and the degree of obesity was evaluated using body mass index (BMI), percent body fat (PBF), and waist-hip ratio (WHR). The state of nasal cavity was evaluated by color, humidity, and swelling of the mucous membranes, and runny nose. Results BMI, PBF, and WHR were higher in patients with craniofacial hyperhidrosis than in patients with palmar/plantar hyperhidrosis. Rhinitis score was not significantly different between craniofacial hyperhidrosis and palmar/plantar hyperhidrosis. There was a positive correlation between rhinitis score and DLQI. Conclusions The degree of obesity was higher in patients with craniofacial hyperhidrosis than in those with palmar/plantar hyperhidrosis. The state of nasal cavity was not significantly different between craniofacial hyperhidrosis and palmar/plantar hyperhidrosis, but was associated with quality of life of hyperhidrosis patients.

• The Korean Journal of Pain
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• v.14 no.1
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• pp.56-60
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• 2001

Background: Conventional thoracoscopic sympathectomy or sympathicotomy is an effective method in treating localized hyperhidrosis; however, this may result in a postoperatively compensatory hyperhidrosis or facial anhidrosis in the treatment of palmar hyperhidrosis. We modified the conventional sympathicotomy by limiting the extent of nerve transection (limited T3 sympathicotomy) since May 1998. However, there are many reports of a good short-term outcome of limited T3 sympathicotomy. Therefore, we reviewed long-term follow-up of limited T3 sympathicotomy based on outcomes analysis using a questionnaire. Methods: Fifty four patients with palmar hyperhidrosis underwent a limited T3 sympathicotomy between May 1998 and March 1999 and had a complete follow-up over two years using a questionnaire (the mean follow-up was 2.6 years). The patients' postoperative satisfaction was determined by their subjective responses to the questionnaires; the degree of compensatory hyperhidrosis, the effects on foot hyperhidrosis, gustatory hyperhidrosis and facial dryness, and recurrence, and patient's satisfaction. Results: Of the total, 87% of patients had a compensatory hyperhidrosis and 3.7% of them were disabled. 31.5% of patients showed improvement in foot hyperhidrosis, while 68.5% of patients demonstrated no change or got worse. 31.5% of patients had gustatory hyperhidrosis and facial dryness and 22.2% of patients showed a mild palmar hyperhidrosis. The postoperative patients' satisfaction was significantly in 96.3% of patients. Conclusions: The limited T3 sympathicotomy is a highly effective treatment of palmar hyperhidrosis and has a low rate of postoperative compensatory hyperhidrosis, gustatory hyperhidrosis, and facial dryness.

• Journal of Korean Neurosurgical Society
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• v.41 no.1
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• pp.27-29
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• 2007

Objective : Surgical treatment of focal plantar hyperhidrosis is often unsatisfactory compared to palmar hyperhidrosis. The purpose of this study is to evaluate the effect of lumbar sympathetic radiofrequency neurotomy on plantar hyperhidrosis. Methods : From February 2004 to December 2005, 10 patients [mean age 24.3 male 1, female 9] with the clinical diagnosis of plantar hyperhidrosis were treated by bilateral lumbar sympathetic radiofrequency neurotomy of L3 and L4. Patients' symptom relief, satisfactory rate and side effects related to the procedure were analyzed. Results : Radiofrequency neurotomy was effective in the treatment of focal plantar hyperhidrosis showing excellent [more than 75% improved] outcome in 70% of the patients and good [more than 50% improved] in 30%. Complications related to the surgical procedure, such as sensory dysesthesia and compensatory hyperhidrosis were not detected in any case. Conclusion : The use of radiofrequency neurotomy to ablate the lumbar sympathetic ganglion is a safe and effective treatment option for patients with plantar hyperhidrosis.

• Journal of Korean Neurosurgical Society
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• v.37 no.5
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• pp.354-356
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• 2005

Objective: Thoracoscopic sympathicotomy is effective in treating not only palmar hyperhidrosis, but also axillary hyperhidrosis. But studies for axillary hyperhidrosis accompanying osmidrosis are few. We report the outcome of six axillary hyperhidrosis with osmidrosis with literatures review. Methods: Using a minimally invasive technique, thoracoscopic T3-4 sympathicotomy was performed. The results of sympathicotomy of third and fourth sympathetic chains of six patients from January 1999 to August 2003 for axillary hyperhidrosis with osmidrosis were reviewed. Results: All patients had a successful outcomes, their profuse sweating ceased. Two patients suffered from compensatory hyperhidrosis. Three patients disappeared or diminished foul odor but three patients complained remained osmidrosis. Conclusion: In the treatment of axillary hyperhidrosis, the sympathicotomy of T3 and T4 chain is an effective method but osmidrosis must be treated according to its cause.

• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.486-492
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• 2001

Objective : Essential hyperhidrosis is a pathological condition of excessive sweating beyond that required to cool the body, though poorly understood, originating from a dysfunction of the sympathetic nervous system. Thoracoscopic sympathectomy is the most popular treatment for upper limb hyperhidrosis, because it is a safe, effective, minimally invasive, and time-saving method. However, the common complication is the compensatory hyperhidrosis in other areas of the body, notably on the back, chest, abdomen, and buttocks. Compensatory hyperhidrosis is severe enough for some people, especially those living in a warm climate or engaging in heavy physical activities, to regret ever having had operation. The pathophysiological mechanisms underlying compensatory hyperhidrosis are incompletely understood, even though it is thought to be a truly compensatory feature related to thermoregulation of the body. Materials and Methods : we studied the clinical features of total 233 patients who were diagnosed as essential hyperhidrosis and treated with thoracoscopic sympathectomy or sympathicotomy from March 1992 to July 2000. Results : The success rate of thoracoscopic sympathetic surgery(sympathectomy or sympathicotomy) was 98.7%. The global rate of compensatory hyperhidrosis was 77% ; 84% in group T2, 3 sympathectomy, 76% in group T2 sympathectomy, 43% in group T2, 3 sympathicotomy and 59% in group T2 sympathicotomy. The rate of embarrassing or disabling compensatory sweating was significantly higher in T2 sympathectomy and in T2, 3 sympathectomy than in T2 sympathicotomy and T2, 3 sympathicotomy with significancy in statistic analysis(p<0.01). The precipitating factors of compensatory hiperhidrosis, including heat(warm weather), anxiety, stress, and exertion were noted. The compensatory hyperhidrosis was the main cause of patient dissatisfaction after thoracoscopic sympathectomy. Conclusion : The degree of compensatory hyperhidrosis is closely related to the extent of thoracic sympathectomy.

• The Journal of Internal Korean Medicine
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• v.31 no.1
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• pp.118-127
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• 2010

Objective : Hyperhidrosis is the secretion of sweat in amounts greater than physiologically needed for thermoregulation. Ryodoraku is a physiological function test using electric current, and is closely related to skin sympathetic tone. The aim of this study was to investigate the characteristics of Ryodoraku and association of Ryodoraku with hyperhidrosis. Methods : For this study, we conducted Ryodoraku on 56 people, comprising 33 with palmar-plantar hyperhidrosis and 23 with head-face hyperhidrosis, who visited the 5th Internal Department of the Oriental Medicine Hospital of Kyung Hee University during the period from March 1, 2008 to May 31, 2009. Ryodoraku scores were evaluated and compared by 7 indices(upper, lower, left, right, yin, yang, total score). Results : Ryodoraku scores were significantly higher in hyperhidrosis patients than the normal group. Ryodoraku scores of palmar-plantar hyperhidrosis patients were significantly higher than of head-face hyperhidrosis patients and the normal group. The difference of Ryodoraku indices among palmar-plantar hyperhidrosis patients were insignificant. In head-face hyperhidrosis patients, the upper index was significant higher than the lower index. Conclusions : In hyperhidrosis patients, all indices were significant higher than lower. The upper/lower ratio was significant higher in head-face hyperhidrosis patients.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.139-143
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• 1995

Hyperhidrosis is the state of abnormal sweating on the palm, sole and axillary region. The main treatment of hyperhidrosis are surgical sympathectomy and a thoracic sympathetic ganglion block with neurolytics. Among them, a thoracic sympathetic ganglion block is used in pain clinic for the treatment of hyperhidrosis. I have successfully performed a thoracic sympathetic ganglion block on a 21 year old female patients with pure alcohol. I concluded that the thoracic sympathetic ganglion block was one of the most effective treatment of hyperhidrosis.

• The Journal of Korean Medicine
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• v.33 no.4
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• pp.37-41
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• 2012

Objectives: This study was aimed to establish the clinical features of the patients suffering from hyperhidrosis, who are willing to visit Oriental clinics. Methods: Forty-six patients with primary hyperhidrosis were enrolled in this study classification, body part of perspiration and its severity, and constitutional differentiation were analyzed. Results: 85.1% of patients were 10 to 39 years old. The body part most complained of hyperhidrosis was the hands and feet at 50%. The portion of Teaeumin, Soumin, and Soyangin was 56.6% 21.1%, and 21.7% respectively. Soumin specifically showed a higher frequency of palmar and plantar hyperhidrosis as 90%. The average score of symptoms was $5.1{\pm}1.7$ by a 10-point self- reporting numeric rating scale (NRS). No statistical difference of NRS score was observed regarding gender, Sasang classification, or hyperhidrosis region. Conclusions: This study provides an overview of hyperhidrosis patients visiting an Oriental clinic, and will be helpful in establishing a strategy for the Korean medicine (KM)-based therapeutic development.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.813-817
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• 1999

Background: Conventional thoracoscopic thoracic sympathectomy or sympathicotomy is an effective method in treating localized hyperhidrosis; however, this may result in a postoperatively embarrassing compensatory hyperhidrosis or facial anhidrosis in the treatment of palmar hyperhidrosis. We modified the conventional sympathicotomy by limiting the extent of nerve transection. The purpose of this study was to assess the result of the limited thoracoscopic sympathetic nerve transection in hyperhidrosis. Material and Method: From May to August 1998, 17 patients underwent limited transection of the sympathetic nerve. For 9 patients with facial hyperhidrosis, we transected only the interganglionic fiber between the first and the second ganglion, whereas the conventional method cuts two interganglionic fibers. Eight patients with palmar hyperhidrosis underwent limited transection of the interganglionic fiber between the second and third ganglion. Result: Sixteen patients had improved symptom postoperatively. There was a recurred facial sweating in 1 patient 1 month after the operation. Among the 9 facial hyperhidrosis patients, postoperative compensatory hyperhidrosis was severe in 4, moderate in 4 and minimal in 1. But in 8 cases of palmar hyperhidrosis compensatory hyperhidrosis was moderate in 3, and minimal in 1, none in 4. Facial sweating was not disturbed postoperatively in all of the palmar hyperhidrosis patients. Conclusion: Limited sympathetic nerve transection is a practical and less invasive method for the treatment of localized hyperhidrosis and may reduce the incidence of compensatory truncal hyperhidrosis and facial anhidrosis in case of palmar hyperhidrosis.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.81-86
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• 1999

Background: Essential hyperhidrosis is a condition with excessive sweating, which may be localized in any parts of the body. Thoracic sympathectomy has been a surgical procedure for the management of hyperhidrosis. Methods: We studied 30 ASA I and II patients suffering from severe hyperhidrosis. Bilateral upper thoracoscopic sympathectomy of $T_{2-4}$ was performed in 30 patients under general anesthesia. Anesthesia was induced with 2.5% thiopental sodium 5 mg/kg and succinylcholine chloride 1 mg/kg and was maintained with enflurane 1~2 Vol% and $N_2O-O_2$ mixture adjusted to maintain $SpO_2$ greater than 96%. During anesthesia, invasive arterial pressure, heart rate, EKG, $SpO_2$ and capnography were monitored. Skin temperature was measured with thermister probes attached to the index finger of each hand. An increase in temperature after cautery confirmed success of the sympathectomy. Results: There were 14 men and 16 women whose ages ranged from 16 to 46 years old (mean age 22.2). Of these patients, 13 patients had complained of palm-sole hyperhidrosis, 9 of palm-sole-axilla hyperhidrosis, 4 of palm-sole-face hyperhidrosis and 4 of palm-sole-axilla-face hyperhidrosis. The provocative factors of excessive sweating were tension and stress from interpersonal relationships. There was positive familial history in 37%. The most common complication was compensatory hyperhidrosis in 23 patients comprising 76%. Other complication included peumothorax (4 patients), hemothorax (1 patient), ipsilateral Horner's syndrome (1 patient) and paresthesia of right arm (1 patient). The degree of satisfaction was graded as good, fair and poor with 15, 12 and 3 patients, respectively. Conclusions: Thoracoscopic sympathectomy with VATS is an efficient, safe and minimally invasive surgical procedure for essential hyperhidrosis.