Dr. Reisfeld’s newly published research

A paper will be published in the Clinical Autonomic Research Journal. It was written by Dr. Rafael Reisfeld and it focuses on the question; Where should the clamps be applied when sympathectomy is performed for patients with severe Palmer hyperhidrosis? With all the difficulties involved in collecting data in a clinical study based upon subjective findings few points are emerging.

The first one is that Endoscopic Thoracic Sympathectomy should be done only for severe cases of excessive hand sweating. The author believes that sympathectomy should not be done for isolated cases of Facial Blushing, Cranio-facial sweating or axillary hyperhidrosis only. The second finding is that the number of cases with severe compensatory sweating is statistically lower when the clamps are applied at the T3-T4 level. Obviously we need years of close follow up to more fully understand the results. The third point is that gustatory sweating almost disappeared when placing the clamps at the right level. Other findings are those of less influence on heart rate and exercise ability. As said before more years of follow up and results are needed to come so more information can be shared.

With regard to the reversal issue there were two recent studies that showed the reversibility after clamp removal is about 50%. Even though it’s not a high it still offers a better chance than doing the nerve graft reversal. This is the reason why there is a trend around the world to use the clamps instead of the cutting or destruction type methods when sympathectomy is done for excessive hand sweating.