I refer to the article on palmar hyperhidrosis by Dr Sanjay Sharma (Managing palmar hyperhidrosis, March). I feel that the adverse effects [of thoracoscopic sympathectomy] are understated by my colleague. For example, compensatory hyperhidrosis is common, and can be disabling, leading to regret about the procedure in some patients (up to 51% in one review). Reversal of the procedure is difficult and requires sural nerve transplant if the sympathetic chain is removed.
The procedure can be effective and worthwhile, but our advice to patients must reflect the true potential outcomes.
Dr Ian Gilfillan, Cardiothoracic Surgeon http://www.medicalhub.com.au/wa-news/letters/3217-palmar-hyperhidrosis-revisitedou