Ottomann C, Blazek J, Hartmann B, Muehlberger T
Zentrum für Schwerbrandverletzte mit Plastischer Chirurgie, Unfallkrankenhaus Berlin Marzahn, Berlin.
Chirurg. 2007 Apr;78(4):356-61. doi: 10.1007/s00104-006-1288-y.
Axillary hyperhidrosis is a dysfunction of the secretion of sweat glands. Conservative treatment modalities are mostly ineffective. Liposuction combined with subcutaneous curettage (TLC) destroys the sweat glands, while Botox injections inhibit the cholinergic transmission.
Of a total of 88 patients, TLC was carried out in 47 and 41 patients received intradermal Botox injections. The effect of both forms of treatment on the quality of life was assessed using a specific hyperhidrosis questionnaire and was correlated with sweat volumes measured by gravimetry.
Follow-up after 6 months showed significantly changed sweat volumes of 52+/-41 mg/min of TLC patients versus 78+/-87 mg/min in the Botox group. In the TLC group 91% and in the Botox group 98% were satisfied with the result.
The stress of a single surgical intervention is to be weighed against the necessary repetitive application of multiple Botox injections. Both methods are superior to other, more radical surgical methods in terms of efficacy and complication rates. Botox and TLC lead to a significant improvement of the quality of life.
腋窝多汗症是汗腺分泌功能障碍。保守治疗方法大多无效。抽脂联合皮下刮除术（TLC）可破坏汗腺，而肉毒杆菌毒素注射可抑制胆碱能传递。
总共88例患者，47例行TLC，41例行皮内肉毒杆菌毒素注射。使用特定的多汗症问卷评估两种治疗方式对生活质量的影响，并与重量法测量的汗液量相关联。
6个月后的随访显示，TLC组患者汗液量显著变化为52±41毫克/分钟，肉毒杆菌毒素组为78±87毫克/分钟。TLC组91%、肉毒杆菌毒素组98%对结果满意。
单次手术干预的压力需与多次重复注射肉毒杆菌毒素的必要性相权衡。两种方法在疗效和并发症发生率方面均优于其他更激进的手术方法。肉毒杆菌毒素和TLC可显著改善生活质量。
