- 期刊
Uniportal Endoscopic Thoracic Sympathicotomy for Craniofacial Hyperhidrosis (Analysis of 42 Cases)
內視鏡胸交感神經截斷術治療顱顔面多汗症（四十二例病例分析）
摘要
背景：雙手及腋汗多汗症是較常見而且困擾許多人的問題。但是，有關探討治療顱顏面多汗的文章較少。 方法：我們從1995年七月至1999年五年，共收集了42例顱顏面多汗，而且已造成社交困擾的病患施行手術，其中19位是男性，23位是女性，他們年齡從22歲到58歲不等，平均年齡是39.8歲。所有病人皆在半坐臥姿勢下，採用單管氣管插管麻醉下施行手術。我們使用兩側腋下單一切口，藉著一個八毫米零度之胸腔鏡，在兩側第貳根肋骨上作星狀神經節下三分之一段的神經截斷術。 結果：手術後所有病人的症狀皆獲得改善。手術後併發症很少，有一位發生輕微肺塌陷，但是不需要特別處理。手術後有34人(80.9%)發生代償性出汗問題，主要分佈在背部和下半身，但是不會造成困擾。沒有手術死亡病例。術後追蹤12到46個月不等（平均是31.9個月）。手術後頭兩年沒有人有症狀復發現象；第三、四年有壹位患者有臉部有輕微出汗現象。 結論：整體而言，內視鏡胸交感神經截斷術治療顱顏面多汗症，是一種簡單安全而且有效的治療方法。
並列摘要
Background: Craniofacial hyperhidrosis is an unusual syndrome of facial sweating that became cosmetically embarrassing. We design this procedure to investigate whether endoscopic thoracic sympathicotomy of the lower part of the stellate ganglion is efficient and safe for craniofacial hyperhidrosis. Methods: Between July 1995 to May 1999, A total of 42 patients with craniofacial hyperhidrosis underwent endoscopic sympathicotomy. There were 19 males and 23 females with a mean age of 39.8 years old (range 22 to 58 years). All patients were placed in a semi-sitting position under single-lumen intubated anesthesia. We performed ablation of the lower part of the stellate ganglion at the second rib in patients with craniofacial hyperhidrosis and a similar procedure for the T2 ganglion and the lower third of the stellate ganglion at the third and second ribs in patients with both craniofacial and palmar hyperhidrosis using an 8mm, 0-degree thoracoscope (Karl Storz Company, Germany) via one 0.8cm incision just below each axilla. Questionnaires were sent to all patients. Results: Among these 42 patients, 84 sympathicotomies were performed. TES was usually accomplished within 20 minutes (range 10 to 26 minutes). The surgical complication was minimal: one segmental atelectasis of the lung (2.4%). There was no surgical mortality case. The mean postoperative follow-up period was 31.9 months (range 12 to 46 months). The result of TES was highly satisfactory in most patients although 34 patients (80.9%) developed compensatory sweating of the trunk and lower limbs. The recurrence rates of craniofacial hyperhidrosis were 0% in the first year, 0% in the second year, 2.4% in the third year, and 2.4% in the fourth year. Conclusions: Endoscopic thoracic sympathicotomy of the lower third of the stellate ganglion is a simple, safe and effective method for treating craniofacial hyperhidrosis.