New Device (Lotan's Hook) for Endoscopic Thoracic Sympathectomy in the Treatment of Primary Palmar Hyperhydrosis in Children

Abstract

Background

: Hyperhydrosis is defined as sweating in excess of the physiologic needs of the individual. Special circumstances, such as excessively hot ambient temperature or anxiety states, may exacerbate the phenomenon. Involvement of the hands (palmar hyperhydrosis) may lead to excessive disruption of day-to-day activities, which may become manifest either socially, during schooling, or at the place of employment. Children who suffer from primary hyperhydrosis may suffer severe, and at times irreversible, interference with their quality of life. The most effective treatment for primary idiopathic hyperhydrosis is severance of the sympathetic nerve at the level of thoracic vertabrae T₂-T₃.

Patients and Methods

: This paper summarizes the results in 100 consecutive children suffering from hyperhydrosis who were treated by minimally invasive surgery between 1994 to 1998. Their mean age was 12 years (range 7-18). All were operated on by an identical technique using a special hook (Lotan's hook) that was developed in our department.

Results and Conclusions

: The success of the treatment, the short duration of hospitalization, and the small number of complications encountered in this series justify this thoracoscopic approach to the treatment of upper limb hyperhydrosis even in relatively young patients.