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Eur J Cardiothorac Surg 2008;33:1157-1158. doi:10.1016/j.ejcts.2008.03.033
Copyright © 2008, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Christopher Andrew Efthymiou
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Case reports

Compensatory hyperhidrosis: a consequence of truncal sympathectomy treated by video assisted application of botulinum toxin and reoperation

Christopher Andrew Efthymiou, James Andrew Charles Thorpe*

Department of Thoracic Surgery, St James’ Hospital, Beckett Street, Leeds, LS9 7TF, United Kingdom

Received 8 February 2008; received in revised form 9 March 2008; accepted 11 March 2008.

* Corresponding author. Tel.: +44 113 3925 737; fax: +44 113 3926 657. (Email: thorpyat{at}aol.com).

Hyperhidrosis is a debilitating condition characterised by sweating that exceeds the need of normal thermoregulation. Surgical management of primary hyperhidrosis by upper dorsal sympathectomy is the treatment of choice for intractable hyperhidrosis, however, paradoxically it may be followed by troublesome compensatory hyperhidrosis in a significant number of patients. The frequency of compensatory hyperhidrosis often reflects the extensiveness of the denervation. We report for the first time the successful treatment of a patient who developed compensatory hyperhidrosis following sympathectomy using video assisted extension of the sympathectomy by application of botulinum toxin (BTX-A). In addition, this case highlights the use of botulinum toxin as a guide for the potential successful management of compensatory hyperhidrosis prior to definitive extension of a sympathectomy.

Key Words: Palmar axillary hyperhidrosis • Compensatory sweating • BTX-A botox • Sympathectomy






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Copyright © 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.