Tarık PURTULOĞLU, Süleyman DENİZ, Abdülkadir ATIM, Şükrü TEKİNDUR, SEDAT GÜRKÖK, Ercan KURT

A new target of percutaneus sympathic radiofrequency thermocoagulation for treatment of palmar hyperhidrosis: T4

Amaç: Hiperhidrozun sempatik sinir sisteminin fonksiyonel bozukluğu sonucu oluştuğu düşünülmektedir. Bu çalışmada, konservatif tedaviye yanıt vermeyen palmar hiperhidrozun tedavisinde perkütan T4 sempatik radyofrekans (RF) termokoagülasyon, güvenlik, verimlilik ve hasta memnuniyeti açısından değerlendirildi. Gereç ve Yöntem: Bu çalışma, 16-48 yaş arası 15 hastanın düzenli kayıtlarından elde edilen veriler geriye dönük olarak incelenerek yapıldı. Hasta memnuniyeti skoru (memnun değil, memnun, çok memnun), tedavi sonrası elin durumu (kuru, hafif kuru, hiçbir iyi- leşme yok) ve en sık rastlanan komplikasyon olan kompansatuvar hiperhidroz (KH) derecesi (hiç yok, hafif, orta, şiddetli) incelendi. Bulgular: Bir hastada 2 saat süren öksürük krizi, 1 hasta geçici bradikardi ve tüm vakalarda geçici enjeksiyon yerinde ağrı dışında herhangi bir komplikasyon gözlenmedi. İki hastada 1. haftada, üç hastada da 1., 2. ve 6. aylarda nüks gelişti. Sonuç: Perkütan sempatik T4 RF termokoagülasyon ile ablasyon uzun vadeli (6 ay) hasta memnuniyeti (%80) sağlamıştır. Ayrıca el terlemesinde (kuru veya hafif kuru %80) etkili azaltma gözlendi. KH oranı %27 idi. Bu sonuçlarına göre, perkütan sempatik T4 RF termokoagülasyonun yüksek hasta memnuniyeti ile güvenli ve etkili bir tedavi yöntemi olduğu düşüncesindeyiz.

Palmar hiperhidroz tedavisinde perkütan sempatik radyofrekans termokoagülasyonda yeni hedef: T4

Objectives: Hyperhidrosis is thought to result from a functional impairment of the sympathic nervous system. In this study, percutaneous T4 sympathic radiofrequency (RF) thermocoagulation was used to treat palmar hyperhidrosis which does not respond to conservative treatment. The results were evaluated in terms of safety, efficiency and patient satisfaction. Methods: In this study, 15 patients aged 16-48 years were retrospectively evaluated from prior records. Patient satisfaction scores (very satisfied, satisfied, not satisfied), after treatment of the hand condition (dry, mild dry, no improvement), and whether the most common complication and most patients expressed by the compensatory hyperhidrosis (CH) degree (none, mild, moderate, severe) were analyzed. Results: No complications were observed except a coughing crisis that lasted for 2 hours in one patient, transient bradycardia in 1 patient and transient injection site pain in all cases. Two patients 1 per week and three patients 1, 2 and 6 months devel- oped recurrence. Conclusion: Sympathic T4 ablation with RF thermocoagulation was found to have long term (6 months) patient satisfac- tion (80%). It was also effective in reducing the hand sweating (80% dry or mild dry). The CH rate was 27%. According to our results, sympathic T4 ablation with RF thermocoagulation is a safe and effective treatment with a high degree of patient satisfaction.

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