Aşik Züleyha Soytürk, Orbey Başak Ceyda, Aşik Ibrahim
Department of Dermatology, ZTB Hospital, Ankara, Turkey.
Agri. 2008 Jul;20(3):37-9.
Patients with hyperhidrosis suffer from physical, social and mental discomfort which often cannot be treated sufficiently using conservative measures. A new percutaneous approach to sympathectomy using radiofrequency denervation has seemed to offer longer duration of action and less incidence of post sympathetic neuralgia. This article reports the authors' experience with sympathetic RF neurolysis in a 35 year old male with right unilateral lumbar hyperhidrosis. Under scopy guided localization of the lumbar spine sympathetic blockade with local anesthetics to L2-5 vertebral levels were performed as a diagnostic block. Lesion effectiveness is monitored by bilateral feet skin temperature measurement. Clinical effects produced by the first sympathetic ganglion block were sustained for 1 week and then RF neurolysis of lumbar sympathetic ganglion was performed to the same levels for a longer effect. The procedure was accomplished within 30 minutes and the patient was discharged within 2 hours after the procedure. Hyperhidrosis was relieved after the procedure and there were no postsympathectomy neuralgia and sexual dysfunction. The patient obtained improvement of lumbar hyperhidrosis at his first month of follow- up and was satisfied with the outcome. In conclusion, RF neurolysis of lumbar sympathetic ganglions is a safe and effective palliative procedure with minimal invasiveness for relieving excessive sweat secretion in patients with localized hyperhidrosis.
多汗症患者遭受身体、社交和精神上的不适，而采用保守措施往往无法充分治疗。一种新的经皮射频去神经交感神经切除术似乎能提供更长的作用持续时间，且交感神经切除术后神经痛的发生率更低。本文报告了作者对一名35岁右侧单侧腰部多汗症男性患者进行交感神经射频消融术的经验。在腹腔镜引导下，用局部麻醉剂对腰椎进行交感神经阻滞定位至L2 - 5椎体水平作为诊断性阻滞。通过双侧足部皮肤温度测量监测病变效果。首次交感神经节阻滞产生的临床效果持续了1周，然后对相同水平的腰交感神经节进行射频消融以获得更长时间的效果。手术在30分钟内完成，患者术后2小时出院。术后多汗症得到缓解，且无交感神经切除术后神经痛和性功能障碍。患者在随访的第一个月腰部多汗症得到改善，对结果满意。总之，腰交感神经节射频消融术是一种安全有效的姑息性手术，对缓解局限性多汗症患者的过度出汗分泌具有微创性。
