{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T07:39:50Z","timestamp":1787816390696,"version":"build-2784847793"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rofo"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>\n            Purpose\u2002The objective of the present study was to evaluate the benefit of a thoracic, computed tomography-guided sympathicolysis (CTSy) in patients with primary, focal hyperhidrosis of the hands. In addition, the influence of the amount and distribution of the administered sympathicolytic agent was to be assessed.<\/jats:p><jats:p>\n            Patients and Methods\u2002Retrospectively, 78 patients [13 (16.7\u200a%) men, mean age 31.2\u200a\u00b1\u200a9 years and 65 (83.3\u200a%) women, mean age 34.2\u200a\u00b1\u200a12 years], who had been treated using CTSy, were included in the study. The indication for treatment was primary focal palmar hyperhidrosis grade II and grade III after exhaustion of all conservative treatment options and a continued high level of suffering. CTSy was performed after establishing the entry plane at the level of the intervertebral space T2\u200a\/\u200aT3 via a dorsolateral approach using a 22-G coaxial needle. On average 5 (2\u201310) ml of a sympathicolytic mixture (10\u200aml consisting of 8\u200aml 96\u200a% alcohol, 1.6\u200aml 0.5\u200a% Carbostesin and 0.4\u200aml 0.9\u200a% NaCl solution, with added amounts of contrast medium) were instilled. The volume of distribution of the sympathicolytic agent was determined in craniocaudal direction using CT images. The patients evaluated their sense of discomfort preinterventionally, 2 days postinterventionally, and 6 and 12 months after the intervention, on the basis of a Dermatology life Quality Index (DLQI) as well as the side effects that occurred.<\/jats:p><jats:p>\n            Results\u2002The technical success rate of CTSy was 100\u200a%. No major complications occurred. The interventions performed led to a significant reduction (p\u200a&lt;\u200a0.001) in the preinterventional sense of discomfort 2 days, 6 and 12 months after CTSy. As the most common side effect, compensatory sweating was reported by 16\/78 (20.5\u200a%) of the patients over the further course. In all of these patients, the volume of sympathicolytic agent administered was below 5\u200aml. In no case did the sympathicolytic agent extend caudally beyond the base plate of Th\u00a03. No compensatory sweating of the back was observed in 5\/78 (6.4\u200a%) patients; here the sympathicolytic volume was above 5\u200aml and extended significantly caudally below the baseplate of T3.<\/jats:p><jats:p>Transient miosis and ptosis was found in 8\/78 (10.3\u200a%) patients. In all of these patients, the volume of sympathicolytic agent administered was above 5\u200aml and it extended markedly cranially beyond the upper plate of T2. A mild to moderate recurrent sweating developed in 35\/78 (44.9\u200a%) patients, which was more marked if the volume of sympathicolytic administered was below 5\u200aml and slightly more pronounced on the left than on the right. Given a high level of satisfaction overall, 71\/78 (91.0\u200a%) patients said that they would undergo the intervention again.<\/jats:p><jats:p>\n            Conclusion\u2002For patients with primary, focal palmar hyperhidrosis CTSy represents a therapeutic option that offers good benefit and has few side effects. The amount and spatial distribution of the sympathicolytic agent has an influence on the therapeutic outcome and the side effects.<\/jats:p><jats:p>\n            Key Points:\n          <\/jats:p><jats:p>\n            Citation Format\n          <\/jats:p>","DOI":"10.1055\/a-1299-2098","type":"journal-article","created":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T23:59:36Z","timestamp":1608595176000},"page":"574-581","source":"Crossref","is-referenced-by-count":4,"title":["CT-assisted thoracic sympathicolysis for therapy of primary hyperhidrosis palmaris-retrospective analysis of the influence of the\u00a0amount and position of the sympathetic agent on the therapeutic outcome and side effects"],"prefix":"10.1055","volume":"193","author":[{"given":"Julian Ramin","family":"Andresen","sequence":"additional","affiliation":[{"name":"Medical School, Sigmund Freud Private University, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Scheer","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology\/Neuroradiology, Westk\u00fcstenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, L\u00fcbeck and Hamburg, Heide, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Schl\u00f6ricke","sequence":"additional","affiliation":[{"name":"Department of Visceral, Thoracic and Vascular Surgery, Westk\u00fcstenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, L\u00fcbeck and Hamburg, Heide, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reimer","family":"Andresen","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology\/Neuroradiology, Westk\u00fcstenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, L\u00fcbeck and Hamburg, Heide, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,12,21]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.jaad.2003.12.029","article-title":"Recognition, diagnosis and treatment of primary focal hyperhidrosis","volume":"51","author":"J Hornberger","year":"2004","journal-title":"J Am Acad Dermatol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1016\/j.jaad.2010.03.013","article-title":"Clinical differentiation of primary from secondary hyperhidrosis","volume":"64","author":"H W Walling","year":"2011","journal-title":"J Am Acad Dermatol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.ramb.2012.11.002","article-title":"Effectiveness of oxybutynin for treatment of hyperhidrosis in overweight and obese patients","volume":"59","author":"N Wolosker","year":"2013","journal-title":"Rev Assoc Med Bras (1992)"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/j.jaad.2018.12.071","article-title":"The etiology, diagnosis, and management of hyperhidrosis: A comprehensive review: Etiology and clinical work-up","volume":"81","author":"S Nawrocki","year":"2019","journal-title":"J Am Acad Dermatol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1590\/abd1806-4841.20175551","article-title":"Epidemiologic analysis of revalence of the hyperhidrosis","volume":"92","author":"F A Estevan","year":"2017","journal-title":"An Bras Dermatol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s004640080042","article-title":"Thoracoscopic sympathectomy for palmar hyperhidrosis","volume":"45","author":"M Hashmonai","year":"2001","journal-title":"Surg Endosc"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jaad.2003.12.040","article-title":"US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey","volume":"51","author":"D R Strutton","year":"2004","journal-title":"J Am Acad Dermatol"},{"key":"ref8","first-page":"387","article-title":"Computed tomography guided thoracic sympathicolysis for palmar hyperhidrosis","volume":"39","author":"A Lucas","year":"1998","journal-title":"J Cardiovasc Surg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1590\/abd1806-4841.20153859","article-title":"Research of primary hyperhidrosis in students of medicine of the State of Sergipe, Brazil","volume":"90","author":"S O Lima","year":"2015","journal-title":"An Bras Dermatol"},{"key":"ref10","first-page":"9","article-title":"Surgical treatment of palmar hyperhidrosis before thoracoscopy: experience with 475 patients","volume":"572","author":"R Adar","year":"1994","journal-title":"Eur J Sur"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"83","DOI":"10.3949\/ccjm.53.1.83","article-title":"Essential hyperhidrosis. 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