Improved quality of life after sympathetic block for upper limb hyperhidrosis

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Abstract
Background The aim of the study was to assess two disease-specific quality of life (QoL) instruments after limited endoscopic thoracic sympathetic block (TS) at T4 for upper limb hyperhidrosis. Methods Between 2001 and 2005, 112 patients underwent 223 TS procedures in a prospective study. Some 103 patients (92·0 per cent) had palmar, 87 (77·7 per cent) had axillary and 75 (67·0 per cent) had combined hyperhidrosis. QoL questionnaires devised by Keller et al. and Milanez de Campos et al. were employed before and after treatment. Mean(s.d.) follow-up was 21·9(10·1) months. Results A total of 106 patients (94·6 per cent) were evaluated. All patients with palmar hyperhidrosis were completely or almost dry after surgery. Side-effects of compensatory sweating and gustatory sweating were observed in 17·0 and 28·3 per cent of patients respectively. QoL improved after TS in 100 per cent (Keller) and 97·3 per cent (Milanez de Campos) of patients illustrated by ameliorated scores of 78·7 and 67·8 per cent, respectively (both P < 0·001). Both questionnaires showed that compensatory sweating resulted in reduced postoperative QoL (P = 0·011, Keller; P = 0·032, Milanez de Campos). Conclusion Endoscopic sympathetic block at T4 leads to improved QoL. Both current questionnaires fulfilled validation criteria for disease-specific QoL instruments in upper limb hyperhidrosis.