In hyperhidrosis, surgical intervention is an option in addition to drug therapy.
Endoscopic thoracic sympathectomy (ETS) [ultima ratio therapy].
- This procedure is the surgical transection of individual ganglia (accumulation of nerve cell bodies in the peripheral nervous system) of the sympathetic nervous system for the treatment of hyperhidrosis.
- Indication: this procedure can be performed for palmar (affecting the palm of the hand) hyperhidrosis; in this case, the sympathetic ganglia Th 2/3 are removed
- The success rate is up to 79
- Hyperhidrosis in other parts of the body must be expected as an important side effect; other important side effects include hematothorax (accumulation of blood in the pleural space; the pleura lines the lungs and chest), pneumothorax (life-threatening condition in which air enters the pleural space, obstructing the expansion of one lung or both lungs; this results in inability or limitation of breathing), and Horner syndrome (trias: Miosis (pupillary constriction), ptosis (drooping of the upper eyelid) and pseudoenophthalmos (apparently sunken eyeball)) and vascular injuries.
Curettage/liposuction (aspiration hydrectomy).
- This procedure is a combination of curettage (the dermis is curetted from the inside, i.e. in the lowest layers with a sharp spoon, i.e. scraped out) and liposuction (liposuction). This involves superficial liposuction of the tissue under the dermis with the sweat glands contained therein.
- Indication: this procedure is considered for hyperhidrosis of the axillary (affecting the armpit) sweat glands.
- The success rate is up to 90%
- The main side effects are wound infections, skin changes or scarring.
