Is Clipping the Sympathetic Chain Effective for Palmar Skin Temperature?

Reply to Letter to the Editor

We read the article by Findikcioglu and colleagues, “Is clipping superior to cauterization in the treatment of palmar hyperhidrosis?” and would like to add our thoughts to this discussion.[1] Thoracic sympathectomy is being done in our clinic successfully since 2010. With our clinical experience, we perform “T2 protective” sympathectomy to minimalize the compensatory hyperhidrosis. Clip applications are useful in craniofacial hyperhidrosis and Raynaud syndrome.

We perform this with two ports over the T2 sympathetic ganglion as we do not want Horner syndrome or compensatory hyperhidrosis. We have not seen any complications with the “clipping” method in our 10 cases. We evaluate the effectiveness of surgery during operation with the palmar temperature monitoring simultaneously. We consider an increase of 0.5 degrees as significant.[2]

• References

• 1 Findikcioglu A, Kilic D, Hatipoglu A. Is clipping superior to cauterization in the treatment of palmar hyperhidrosis?. Thorac Cardiovasc Surg 2014; 62 (5) 445-449
• 2 Oncel M, Sudam GS, Karabagli H , et al. Palmar skin temperature importance during transthoracic endoscopic sympathectomy for palmar hyperhidrosis. J Neurol Sci 2012; 29 (2) 285-290