Department of Anesthesiology Medical School National Yang-Ming University Taipei Taiwan.
Pain Clinic Taipei City Hospital Taipei Taiwan.
Brain Behav. 2017 Sep 26;7(11):e00833. doi: 10.1002/brb3.833. eCollection 2017 Nov.
Palmar hyperhidrosis (PH) exhibits excessive and unpredictable sweating. The most effective treatment for permanent cure is the ablation of thoracic sympathetic ganglia innervating hands. However, sympathectomy of T2 sympathetic ganglion by clipping or cauterization causes irreversible nerve damage, and results in a compensatory hyperhidrosis (CH). We herein used the pulsed radiofrequency (PRF) stimulation to reversibly block sympathetic ganglion to treat PH and avoid CH.
A bipolar electrode was implanted into the right T2 sympathetic trunk by endoscopic surgery and PRF was delivered through the electrode. The humidity (%) of right palm was measured to indicate sweating level.
Six out of 13 rats (46.2%) that received a 5-min PRF stimulation on the T2 sympathetic trunk showed a decrease in the right palm humidity during the surgery. PRF stimulation significantly reduced humidity from 69.17% ± 0.72% obtained from baseline condition to 66.93% ± 0.69%. The humidity reduction was also observed at 10 min after the PRF stimulation. We further evaluated the effect of PRF stimulation 1 week after surgery and found that the PRF stimuli reduced right hand humidity in 5 out of 8 rats (62.5%). PRF stimulation significantly reduced humidity from 66.11% ± 0.81% obtained from sham operation control to 63.62% ± 0.82%. The percentage of right hand humidity obtained 10 min after PRF stimulation was also reduced to 63.38% ± 0.80%. Anesthetics have no effect on humidity.
These results indicate that PRF stimulation of T2 sympathetic trunk reduces palm sweating in rats.
手掌多汗症(PH)表现为过度和不可预测的出汗。永久性治愈的最有效治疗方法是切除支配手部的胸交感神经节。然而,通过夹闭或烧灼 T2 交感神经节会导致不可逆转的神经损伤,并导致代偿性多汗症(CH)。我们在此使用脉冲射频(PRF)刺激来可逆性阻断交感神经节治疗 PH 并避免 CH。
通过内窥镜手术将双极电极植入右侧 T2 交感干,通过电极传递 PRF。测量右手掌的湿度(%)以指示出汗水平。
在 T2 交感干上接受 5 分钟 PRF 刺激的 13 只大鼠中有 6 只(46.2%)在手术过程中右手掌湿度降低。PRF 刺激使湿度从基线条件下的 69.17%±0.72%显著降低至 66.93%±0.69%。在 PRF 刺激后 10 分钟也观察到湿度降低。我们进一步评估了手术后 1 周 PRF 刺激的效果,发现 PRF 刺激使 8 只大鼠中的 5 只(62.5%)右手湿度降低。PRF 刺激使假手术对照组获得的 66.11%±0.81%湿度显著降低至 63.62%±0.82%。PRF 刺激后 10 分钟获得的右手湿度百分比也降低至 63.38%±0.80%。麻醉剂对湿度没有影响。
这些结果表明,T2 交感干的 PRF 刺激可减少大鼠手掌出汗。