Two patients with gustatory hyperhidrosis complaining of discomfort during usual activities were relieved of sweating by using anticholinergic benztropine. Herein, we report two cases of gustatory hyperhidrosis treated with benztropine.
Benztropine* ; Humans ; Hyperhidrosis ; Sweat ; Sweating ; Sweating, Gustatory*

No abstract available.
Hyperhidrosis*

No abstract available.
Hyperhidrosis

BACKGROUND: This study was designed to evaluate the effectiveness of T3 sympathicotomy in treatment of palmar hyperhidrosis. MATERIAL AND METHOD: During the period of June to December 1998, 50 patients (24 females and 26 males) suffering from palmar hyperhidrosis either in isolation (n=37) or in combination with axillary hyperhidrosis (n=13) were operated. The mean age of the patients was 20 years. The bilateral sympathetic trunks were severed on the 3rd rib (2nd and 3rd ganglia) for the isolated palmar hyperhidrosis and on the 3rd and 4th ribs for the combined type using electrocoagulation scissors. A linear analogue scale was used to assess the degree of sweating on the palms, face, trunk, and feet (ranged 0 to 10:0 = anhidrosis: 10 = excessive sweating) as well as the patient's satisfaction with the surgery (ranged 0 to 10:0 = regret; 10 = completely satisfied). RESULT: All of the patients were relieved from palmar hyperhidrosis. A mean palmar sweat production score after T3 sympathicotomy was 1.5+/-0.8. Some degree of compensatory sweating had occurred in 39 patients (78%) with a mean score of 3.4+/-1.6. Gustatory sweating occurred in 2 patients (4%). The mean score of the patient's satisfaction after the surgery was 8.5+/-1.2. CONCLUSION: Palmar hyperhidrosis can be successfully relieved by the T3 sympathicotomy. When considering the advantages of T3 sympathicotomy with respects to a better preservation of facial sympathetic function, less occurrence of severe compensatory sweating, and lower incidence of gustatory sweating. We recommend T3 sympathicotomy as a treatment of choice for palmar hyperhidrosis.
Electrocoagulation ; Female ; Foot ; Humans ; Hyperhidrosis* ; Hypohidrosis ; Incidence ; Ribs ; Sweat ; Sweating ; Sweating, Gustatory ; Thoracoscopy

BACKGROUND: Recently, thoracic sympathicotomy for craniofacial hyperhidrosis (FH) is increasingly avoided contrast to palmar hyperhidrosis. We recently demonstrated that selective T2 sympathicotomy for FH in woman might be recommended because of differences of the postoperative satisfaction between man and woman. Therefore, this study was designed to analyze the postoperative long?term results, evaluate the effectiveness of T2 sympathicotomy and establish the new strategy in treatment of FH in woman. MATERIAL AND METHOD: From May 1998 to July 2001, 27 cases of FH in woman that were performed T2 sympathicotomy and minimum 2 years have passed since then at the follow up period. Among them, 20 cases were evaluated by telephone review and medical record. Bilateral sympathetic trunks were severed on the 2nd rib with 2mm thoracoscopic instruments. 7 patients combined with gustatory sweating (GS). Ages ranged from 25 to 62 (mean age, 46.4 years). RESULT: All patients were relieved of symptom immediately after operation. At postoperative 1 week, all patients were satisfied: 15 patients, "very satisfaction" and 5 patients, "relatively satisfaction". However, during long?term follow?up period (from 25 to 63 months postoperatively), 9 patients (45%) were relatively satisfied, 8 patients (40%) complained that there was no difference of postoperative satisfaction and 3 patients (15%) complained of non?satisfactory results (regret for surgery). 16 patients (80%) had complaint of uncomfortable feeling because of postoperative GS. Some degree of compensatory sweating (CS) had occurred in all patients: severe 10 patients (50%), severe but acceptable 6 patients (30%), and just conventional 4 patients (20%). The sites of CS were trunk, back, axilla and extremities. CONCLUSION: Thoracoscopic T2 sympathicotomy is relatively considerable method for FH in woman and the postoperative satisfaction depends on GS and the degree of individual adaptation for CS. Therefore, it is required that the prediction of preoperative risk factors for GS and CS and then careful selection of patients to increase the postoperative satisfaction, and the development of acceptable new treatment modalities.
Axilla ; Extremities ; Female ; Follow-Up Studies ; Humans ; Hyperhidrosis* ; Medical Records ; Ribs ; Risk Factors ; Sweat ; Sweating ; Sweating, Gustatory ; Telephone ; Thoracoscopy

OBJECTIVE: Craniofacial hyperhidrosis patients have as much difficulty in personal relationships as palmar and axillary hyperhidrosis patients. Thoracoscopic sympathectomy for facial hyperhidrosis has been known to resect T1 ganglion, however, its inherent complications such as Horner's syndrome make surgeons hesitant to this method. We report the T2 sympathicotomy to treat craniofacial hyperhidrosis. METHODS: From June 2000 to July 2001, eight consecutive craniofacial hyperhidrosis patients underwent bilateral limited T2 sympathicotomy with 2mm-diameter endoscopes. Based on the follow-up from five to 23 months, the evaluation was made on the surgical outcomes, postoperative complications and patient satisfaction. RESULTS: All patients were relieved of excessive sweating in their faces and scalps. Complications related to the surgical procedures, such as Horner's syndrome and compensatory gustatory hyperhidrosis were not detected in any case. CONCLUSION: Limited T2 sympathicotomy has proven to be as effective as T1 sympathectomy and to be less complicated in treating patients with distressing craniofacial hyperhidrosis.
Endoscopes ; Follow-Up Studies ; Ganglion Cysts ; Horner Syndrome ; Humans ; Hyperhidrosis* ; Patient Satisfaction ; Postoperative Complications ; Scalp ; Sweat ; Sweating ; Sweating, Gustatory ; Sympathectomy

Frey syndrome is characterized by profuse facial sweating which is provoked by the taste of food. It has been described as a consequence of upper thoracic sympathicotomy. Botulinum toxin injection is a relatively new treatment modality for Frey syndrome. Botulinum toxin type A (Botox , Allergan, USA) had been successfully used to treat Frey syndrome occurring in a 38-year-old patient following thoracic sympathicotomy for palmar hyperhidrosis. A total dose of 100U of botulinum toxin (1.0U/0.1ml/cm2) injection resulted in a 6 months' resolution of sweating, burning, and flushing sensation on eating. During the follow-up period, no systemic side effects were experienced.
Adult ; Botulinum Toxins* ; Botulinum Toxins, Type A ; Burns ; Eating ; Flushing ; Follow-Up Studies ; Humans ; Hyperhidrosis ; Sensation ; Sweat ; Sweating ; Sweating, Gustatory*

BACKGROUND: Thoracoscopic sympathetic block in palmar hyperhidrosis has merits in its immediate responsiveness and recovery. In palmar hyperhidrosis, the level of sympathetic chain to be blocked has been somewhat obscure. MATERIALS AND METHODS: To compare the results of T2 with T2,3 sympathetic block, we retrospectively studied 192 patients (T2 group: 84, T23 group: 108) operated on at SNUH with palmar hyperhidrosis between April 1994 and July 1997. We reviewed medical records and recently interviewed the patients by telephone call. Sex and age distribution between two groups showed no significant differences. We performed sympathectomy at the early phase of the syudy until April 1997, and after then, we adopted sympathicotomy rather than sympathectomy. RESULTS: All patients showed symptomatic improvement after the operation. Mean operation times of T2, T23 groups were 61.3+/-22.5min, 82.7+/-24.8min, respectively (p<0.01). Early postoperative complications, such as Horner's syndrome or chest tube insertion, were not different in two groups. There were no statistical differences of late complications such as compensatory truncal hyperhidrosis, gustatory sweating, and phantom sweating. No patient experienced recurrence of palmar hyperhidrosis during the study period. The only difference was the extent of compensatory truncal hyperhidrosis. The compensatory sweating occurred from axilla to suprapatella in T2 group whereas its extent was from nipple to suprapatella in T23 group. CONCLUSIONS: We concluded that T2 thoracic sympathetic block is mandatory for the treatment of primary palmar hyperhidrosis.
Age Distribution ; Axilla ; Chest Tubes ; Horner Syndrome ; Humans ; Hyperhidrosis* ; Medical Records ; Nipples ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Sweat ; Sweating ; Sweating, Gustatory ; Sympathectomy ; Telephone

Exessive sweating of the palms and soles, is a psychologically and occupationally distressing and sometimes disabling condition. Hyperhidrosis is one of the common abnormalities in autonomic nervous system. There were no specific treatment on hyperhidrosis, so invasive thoracic sympathectomy via axillary thoracotomy or cervical approach had been used. Video-assisted thoracic surgery (VATS) is now mostly performed for treating of the palmar and axillary hyperhidrosis. From March 1996 to March 1997, 15 patients with bilateral palmar hyperhidrosis had been treated by the bilateral thoracic sympathectomy (T2, T3, T4) with thoracoscopic resection. The patient were evaluated preoperative and postoperative Digital Infrared Thermographic Imaging (DITI) at Kyung-Hee University Hospital. There were no case of the thoracotomy conversion. There were 3 complications ; pulmonary edema in 1 case, Horner's syndrome in 1 case, and gustatory hyperhidrosis in 1 case. More than half of the patients also had compensatory sweating in the lower abdomen, the buttocks, the back and the thighs. In conclusion, most of the patients were satisfied with the postoperative results of the thoracoscopic sympathectomy, including no more palmar and axillary sweating, less pain, better cosmetic appearances, decreased sweating of the face and soles. In addition, intraoperative temperature monitoring of the hands could estimate the successful thoracoscopic sympathectomy and the preoperative and postoperative Digital infrared thermographic imaging (DITI) could especially be the technique for the objective manifestation of the successful results of the thoracoscopic sympathectomy.
Abdomen ; Autonomic Nervous System ; Buttocks ; Edema ; Hand ; Horner Syndrome ; Humans ; Hyperhidrosis* ; Occupations ; Pulmonary Edema ; Sweat ; Sweating ; Sweating, Gustatory ; Sympathectomy* ; Thigh ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thoracotomy

BACKGROUND: Thoracic sympathetic block surgery is a safe and effective procedure for palmar hyperhydrosis, and this maintains sufficient moisture and prevents compensatory hyperhidrosis. To avoid compensatory hyperhidrosis, the authors performed sympathetic block surgery just above the R4 level to maintain sympathetic tone affecting the caudal area. MATERIAL AND METHOD: A total of 71 subjects (45 males and 26 females) were categorized into two groups. Group 1 (31 patients, mean age: 25.5 years) had clips placed both on the upper and lower part of R4 sympathetic ganglion, and group 2 (40 patients, mean age: 25.9 years) underwent clipping of the upper part of R4. Telephone surveys were done to collect data on 8 categories, and the average follow up interval was 24.9 months (group 1) and 18.9 months (group 2). RESULT: For group 1, 41.9% experienced no sweating and 48.4% replied they experienced some sweating depending on the surrounding conditions. Group 2 showed that 60% experienced no sweating and 35% replied they experienced some sweating depending on the surrounding conditions. 58.1% in group 1 experienced sweating right after the surgery, and 40.0% in group 2 experienced the same. Group 1 (38.1%) and group 2 (37.5%) replied they experienced no hand dryness and more patients in group 2 than in group 1 had hand dryness, but without uncomfortable symptoms. 71.0% (group 1) and 62.5% (group 2) replied they had no compensatory hyperhidrosis or related symptoms. One patient in group 1 and two in group 2 reported they regretted undergoing the procedure. The regions of compensatory hyperhidrosis were the back, thigh and chest in group 1 and the group 2 reported the back, chest, and abdomen in the order of frequency. Fewer incidences of the gustatory hyperhidrosis were noted in group 2. Most of the patients were satisfied with their treatment. CONCLUSION: Clipping the upper part of the R4 ganglion or R4 sympathetic block are both effective for treating palmar hyperhidrosis and these treatments decrease the occurrence or symptoms of compensatory hyperhidrosis. The upper R4 sympathetic block procedure is easier and safer with fewer incidences of gustatory hyperhidrosis and a higher percentage of patient satisfaction.
Abdomen ; Endoscopy ; Follow-Up Studies ; Ganglia, Sympathetic ; Ganglion Cysts ; Hand ; Humans ; Hyperhidrosis* ; Incidence ; Male ; Patient Satisfaction ; Reflex ; Sweat ; Sweating ; Sweating, Gustatory ; Sympathetic Nervous System ; Telephone ; Thigh ; Thorax