The Changes of Skin Temperature and Sympathetic Skin Response after Thoracic Sympathectomy in Patients with Palmar Hyperhidrosis

ABSTRACT

OBJECTIVE: The purposes of these study were to evaluate the changes of temperature and sympathetic skin response (SSR) before and after sympathectomy in patients with palmar hyperhidrosis and to quantify long standing effect of sympathectomy. METHOD: The SSR and skin temperature were measured before, one day and 30 days after thoracoscopic sympathectomy. SSR was recorded from palm and sole bilaterally. Temperature was recorded on 9 sites of each hand and 11 site of each sole. Patient's satisfaction with operation was assessed by 10-point scale. RESULTS: One day after sympathectomy, the amplitude of SSR was significantly decreased and latency of SSR was delayed in all cases on bilateral palm and sole. However, after sympathectomy 30 days, the amplitude of SSR was normalized in all cases on bilateral sole. All patients who had undergone sympathectomy showed significant clinical improvement. The temperature increased dramatically over 3degrees C on postoperation 1 day and maintained 1.72degrees C higher in post-operation 30 days than pre-operation on both hands. There was no significant difference of temperature among pre-operation and post-operation 1 day and post-operation 30 days on sole. CONCLUSION: Our study proved effect of thoracoscopic sympathectomy to the patients with palmar hyperhidrosis objectively and quantified the decrement of sympathetic tone. Further study is needed for long term follow up over 2 months or more.