Letter to the Editor: Percutaneous Chemical Dorsal ­Sympathectomy for Hyperhidrosis

Sir,

We read with interest the article of Dr. Ebrahim [1]. The use of sympathetic block to treat palmar hyperhidrosis was tested in the past. 2 series were published [2] [3]. The group of Adler noticed a 10% recurrence at 4 months. A subsequent follow-up of their cases [4] revealed 40% recurrences and the method of treating palmar hyperhidrosis by phenol blocks was abandoned by this group of authors. In another study of chemical lumbar blocks performed to treat plantar hyperhidrosis [5], recurrence occurred in 89.9% of patients at 6–18 months. Taking into consideration these medium-term results, we wonder at the overall merits of chemical blocks over surgery for the treatment of primary hyperhidrosis. Dr. Ebrahim has a 1-year follow-up of his patients and already noticed 10% recurrences. We urge him to follow his patients for another year and publish at that time his results.

• References

• 1 Ebrahim KS. Percutaneous chemical dorsal sympathectomy for hyperhidrosis. Min Invasive Neurosurg 2011; 54: 29-32
• 2 Dondelinger RF, Kurtziel JC. Percutaneous phenol block of the upper thoracic sympathetic chainwith computed tomography guidance. Acta Radiol 1998; 28: 511-515
• 3 Adler OB, Engel A, Rosenberger A et al. Palmar hyperhidrosis CT guided chemical percutaneous thoracic sympathectomy. Rofo 1990; 153: 400-403
• 4 Saranga D. Upper thoracic sympathectomy by percutaneous extra-pleural phenol injection under computerized tomography guidance as management of primary palmar hyperhidrosis. MD Thesis, Technion, Israel Institute of Technology, 1992
• 5 Kim WO, Yoon KB, Kil HK et al. Chemical lumbar sympathetic block in the treatment of plantar hyperhidrosis: a study of 69 patients. Dermatol Surg 2008; 34: 1340-1345