What is the role of endoscopic sympathectomy in axillary hyperhidrosis treatment?

Updated: Feb 12, 2019
  • Author: Richard H S Karpinski, MD, FACS; Chief Editor: Gregory Gary Caputy, MD, PhD, FICS  more...
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Answer

ETS interrupts or ablates the high thoracic sympathetic chain to decrease sympathetic tone to the upper extremity and/or face. It is useful for causalgia, unreconstructable vascular disease, and treatment of severe frostbite, Raynaud syndrome, and acrocyanosis, in addition to its usefulness in hyperhidrosis. ETS is carried out under general anesthesia through one or more small insertion incisions. Among other things, sympathectomy results in a relaxation of peripheral arteriovenous connections; this results in vasodilatation of the skin with increased warmth. It also produces a cessation of sweating. Beneficial effects reportedly last as long as 5-10 years.

ETS is now often accomplished on an outpatient basis.


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