Important Advice About ETS

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donmostacho
Posts: 2
Joined: Mon Feb 17, 2014 1:22 am

Important Advice About ETS

Post by donmostacho »

Hi everyone! I have suffered from facial and palmar hyperhidrosis for more than 10 years. I am 25 years old now and I am planning to have ETS in less than 10 days. I am aware of the outcomes and side effects of the surgery. But my big concern is the following: For facial and palmar hyperhidrosis I understand that the resection of ganglions should be from T2 to T4 mainly. However my surgeon is strongly recommending me to have the resection from T1 to T6 in order to avoid risks of recurrence and/or to avoid compensatory sweating to move from my face and palms to my underarms. He reiterated his advice but told me that I have the last word on this matter on how to proceed.

What is the best course of action in this case? I would like to know what are the risks and side effects of undergoing resection of all the upper thoracic nerves (T1 to T6) instead of just T2 to T4. The only additional risk that I have identified so far is that resection of T1 increases the risk of Horner's syndrome.

I really hope you can help me with this. THANKS!

admin
Site Admin
Posts: 382
Joined: Wed Dec 31, 1969 5:00 pm

Re: Important Advice About ETS

Post by admin »

Cutting T-1 is idiotic and never done, while no surgeon with a high experience cuts 6 ganglions these days. Please avoid this surgeon at all cost. I would advise consulting with a few experienced surgeons, and then deciding on what to do. See here for surgeons and their websites:

http://www.no-ets.com/surgeons.html

Good luck.

donmostacho
Posts: 2
Joined: Mon Feb 17, 2014 1:22 am

Re: Important Advice About ETS

Post by donmostacho »

Hi! Thanks for your quick response. I will follow your advice. Still for general knowledge I would like to know what are the risks and side effects of undergoing resection of all the upper thoracic nerves (T1 to T6) instead of just T2 to T4.

slovenec
Posts: 54
Joined: Sun Jan 27, 2013 2:19 am

Re: Important Advice About ETS

Post by slovenec »

Removing more than one ganglion per side will very likely cause horrible compensatory sweating. Specifically, removing both T2 and T3 will almost certainly cause major disturbances to the innervation of the heart (much lower pulse, probably some major changes to the ECG). Removing both T1 will definitely cause bilateral Horner's syndrome. Removing T4-T6 will prevent armpit sweating and even sweating in the area below the nipple line.

ETS is no longer recommended to cure facial sweating. For some unknown reason a disproportionally large percentage of people who get ETS for facial sweating later suffer from unbearable CS. In the previous years to cure facial HH a minimal version of the sympathectomy was tried: at least at Mayo clinic and I think that also dr. Tarfusser used to cut the chain between T1 and T2 and keep the ganglia intact.

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