» Sweating

Sweating

Types and causes of sweating

Top of the page

1. Sweaty hands

Sweaty hands can effectively been treated with ESB 4 procedure. Its cause is often idiopathic and remains obscure; sweaty hands are most probably multifactorial. In some cases they are clearly genetically inherited. Other causes may be psychodynamic.

2. Facial sweating

Facial sweating can effectively be treated with ESB 3 or ESB 4 procedure. It is very often associated with blushing, although not always. Causes of facial sweating may include some difficulties in early childhood, most notably the feeling of being an unwished child.

3. Underarm sweating

This sweating type is the most common. Today there is a means to reduce it, too, without a significant risk of side effects with ESB 4 or 5. It also can be treated locally with Botox treatment.

ETS side effects and ETS-reversal surgery

Top of the page

ETS reversal is performed at the Tilkka Hospital in Helsinki by Dr. Telaranta. See Contact page for more information.

How to proceed

You can have more insight into your possibilities by filling up a follow-up questionnaire to inform us the situation before and after your original ETS. Please see the Contact page for more information.

ETS-reversal

ETS stands for Endoscopic Thoracic Sympathectomy, a surgical procedure in which a portion of the sympathetic nerve trunk in the thoracic region is destroyed. ETS can cause unwanted, compensatory excessive sweating (hyperhidrosis) in some patients. ETS-reversal may in some cases be performed to improve this side effect.

The aim of the surgery

The first aim in correctional surgery is to restore the normal neural pathways in the sympathetic chain. This is done by:/

1. Excision of the scar tissue around the cut nerve ends. This often gives immediate relief in the compensatory hyperhidrosis by stopping the neuropathic feedback hypersensitivity. If pain has been included in the side effects, it is usually right away diminished after this neurolysis.

2. Adding fresh nerve stimuli to the midbrain structures. To accomplish this we transpose the living intercostal nerve to the stellate (T1) ganglion in cases where no decent end to end by-pass grafting is possible. This procedure adds to the possibility of thermoregulatory feedback between the lower sympathetic chain and the midbrain ganglia. Also the energy level may be restored, if damaged in the first surgery. This result is often immediate.

3. Microsurgical nerve reconstruction with a living intercostal nerve graft from inside of the chest wall is in addition used to unite the T1 and T2, possibly T3 and T4 ganglia, sometimes even further down. This way the normal continuity, interrupted by the ETS surgery, is restored and the face and hands usually regain some moisture and the reflex or compensatory sweating is further diminished. We no longer need to take any nerve from the ankle. The final recovery, however, can take more than a year and goes on for several years thereafter.

Comments are closed.