• Dorsal Percutaneous Chemo-sympathectomy for Palmar Hyperhidrosis: A Case Presentation and Surgical Technique

    Final Number:

    Efkan Mustafa Colpan MD

    Study Design:

    Subject Category:
    Functional Neurosurgery

    Meeting: 2016 ASSFN Biennial Meeting

    Introduction: Palmar Hyperhidrosis (PHH) is a functional disorder that negatively effects people both socially and psychologically. Cervical sympathectomy has been reported effective long term treatment for PHH. Author presents a successfully treated PHH case by the Dorsal Percutaneous Chemo-sympathectomy (DCS) and underutilized minimally invasive technique.

    Methods: A 36 years old woman presented with bilateral PHH. Patient did try medical management of PHH but failed. Patient developed social hesitant and troublesome in her job related with bilateral PHH. Patient underwent staged bilateral needle DCS using pure alcohol injection for palmar hyperhidrosis. Procedures were performed under local anesthesia and outpatient setting. Patient was positioned in prone position and percutaneous needle placements for alcohol cervical DCS were performed under fluoroscopy guidance.

    Results: Patient's right sided PHH completely improved immediately after the procedure and the procedure was not complicated. Left sided DCS did provide 30% reduction of PHH. Left sided DCS procedure also complicated with minor Horner's syndrome. Eventually, left sided Horner's symptoms were resolved in five months. Unfortunately, left PHH recurred after nine months from the first procedure. Left sided DCS was repeated. Left sided second DCS procedure was not complicated and provided 90% reduction of PHH. Complete resolution of right PHH and 90% resolution of left PHH were observed on 16 months follow-up.

    Conclusions: DCS is a percutaneous minimally invasive outpatient needle procedure. It is easily repeatable as necessary with the minimally invasive nature of the procedure. DCS provides reasonable Immediate and long treatment effects for PHH.

    Patient Care: Author presents a minimally invasive needle procedure as an available alternative treatment option for palmar hyperhidrosis treatment.

    Learning Objectives: DCS is a minimally invasive needle procedure for treatment of palmar hyperhidrosis.


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