Does the addition of alcohol increase the efficacy of radiofrequency ablation of T2 and T3 sympathetic ganglia in hyperhidrosis?

Abstract

BackgroundWe observe high rate of patient dissatisfaction after radiofrequency (RF) ablation of thoracic sympathetic ganglia in primary hyperhidrosis.ObjectiveWe did this study to test the hypothesis that addition of alcohol injection will cover the anatomical variations in position of sympathetic chain and increase the success rate.Study designRandomized controlled clinical trial.SettingZagazig university hospitals.Patients and MethodsThirty patients were randomly allocated into two groups fifteen for each. Group (ARF) underwent radiofrequency ablation and alcohol injection. Group (RF) underwent radiofrequency ablation only. Patients of both groups were operated upon one side only; immediate dryness and hotness of the operated side were assessed and followed up by a visit to the pain clinic or telephone calls at one week, one month, three months and six months after intervention, also occurrence of complications was assessed and asked about.ResultsImmediate warmth and dryness occurred in 13 of 15 (86.7%) cases of group (ARF) and only 2 started sweating again at six months with 2 patients developed neuropathic pain in axilla for one month. In group (RF), immediate warmth and dryness of the hand occurred in 7 patients of 15 (46.7%) and only 6 patients completed until sex months after intervention. Only one patient developed pain in the axilla for one month after the procedure.LimitationsShort period of follow up and relatively small sample size.ConclusionEfficacy of T2 and T3 sympathetic ablation with radiofrequency and alcohol is significantly higher than their ablation with radiofrequency alone with possible higher incidence of axillary pain.