Hyperhidrosis is a disease characterized by excessive sweating in the hands, armpits, face and feet, which negatively affects human life (daily activities and psycho-social status).
Is it possible to treat hyperhidrosis?
Treatment It is often difficult and various methods are applied. What causes this condition is the overfunctioning of the part of the nervous system called the sympathetic nerve. Thus, treatment options based on damaging the nerves in question by various methods have been developed. These include topical and systemic agents, iontopheresis (galvenotherapy), botox injections, chemical substances and radiofrequency, and sympathectomy that can be performed by surgical methods. Iontophoresis is applied by immersing the hands and feet in static electric water for half an hour, 3 days a week. Although the most commonly used method lately is botox injections applied at 1 cm intervals to excessive sweating areas, its effect usually lasts around 6 weeks and requires repeated applications. Its disadvantages are that it is expensive, causes pain, and has a short duration of effect. In addition, various topical agents (aluminum chloride, glutaraldehyde in ethyl alcohol) can be used and they require repeated applications. The most definitive and permanent treatment method is to block the nerve surgically.
How is the surgical treatment method applied?
In sympathetic nervous system surgery, cutting or burning the sympathetic nerve permanently treats sympathetic disorders. While it was previously performed by making an incision in the chest wall (thoracotomy), today, with the development of video-assisted surgical methods, such surgical procedures can be performed easily and smoothly by experienced surgeons using closed surgery techniques (Endoscopic Thoracic Sympathectomy or clip-on ETS).
Under general anesthesia, every time. It is applied through two small 1-2 cm incisions, one in each armpit. Depending on the patient's complaints, the sympathetic nerves at the 2nd and 3rd spinal levels are cut. The duration of this intervention, which is performed from both armpits, varies between 20 and 40 minutes, depending on the experience of the performing doctor and the operating room staff. Immediately after the surgery, the patient's hand Realizing that the skin is dry is an indication that the result is achieved quickly.
How long does it take to be discharged after the surgery?
The patient who leaves the surgery with a chest drain attached is discharged the next day after the drain is removed, without leaving any visible scars. He returns to his daily life immediately.
What are the problems caused by nerve cutting?
It is not possible for the disruption of sympathetic nerve integrity to affect any other function of the body or cause damage to the body (temporary or permanent paralysis, loss of sensation, etc.).
/> What are the positive results of surgical treatment?
Hand sweating disappears at a rate of 95-100%. Immediately after surgery, hands are warm and dry. Facial flushing disappears in 80-85 out of 100 people, and facial sweating disappears in 95% of the cases. Armpit sweating disappears by 85-90% and foot sweating decreases by 64%. Heart palpitations during excitement decrease. People's self-confidence increases. It increases their success in business and social life.
Are there any side effects that may occur due to surgical treatment?
This surgery is an extremely safe method if performed by an experienced surgeon. However, although rare, some side effects may occur.
· Reflex (compensatory) sweating: It is the most common side effect. It is excessive sweating that occurs in other parts of the body (back, around the belly, hips and behind the knees) after the sweating of the hands, face, armpits and feet disappears. Hand and armpit sweating is seen at a rate of 1% after the operation, facial sweating is seen at a rate of 3-5% after the operation, and facial redness is seen at a rate of 17-20% after the operation.
· Gustatory sweating: It may be seen at a rate of 3%. It does not bother the person much. It is the sweating that occurs on the face or body after consuming certain foods after the operation (seen after consuming bitter or hot foods).
· Horner syndrome: It is not seen in sympathectomy at the level we perform.
· Pneumothorax: Sometimes air remaining in the chest cavity outside the lungs may be observed. . This is called pneumothorax. It mostly goes away on its own. Very rarely, the air in the chest cavity may need to be evacuated by inserting a tube between two ribs.
· Bleeding: In very rare cases, bleeding may occur from the veins between the ribs or from the veins next to the sympathetic chain. This can also be seen and controlled during the operation.
· Intercostal neuralgia: Sometimes, pain may occur in the arms, back and armpits due to damage to the nerves between the ribs at the entry points. It will pass in approximately 1-1.5 months. It does not cause much discomfort to the patient.
Operation details:
· Bilaterally (for both hands and armpits) in a single session, preventing the patient from receiving anesthesia (anesthesia) a second time
· For each side. Surgery is performed through only one entrance hole.
· The patient emerges from the surgery without a drain.
· He can be discharged on the same day.
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