Intradermal Botulinum Neurotoxin Injection Versus Thoracoscopic Sympathectomy in Pediatric Patients with Primary Palmar Hyperhidrosis (Comparative Study)

Authors

1 Department of Plastic Surgery and Burns, Faculty of Medicine –Al-Azhar University

2 Department of pediatric Surgery, Faculty of Medicine –Al-Azhar University

Abstract

Background: Botulinum neurotoxins are injected intradermal into the palm to normalize sweating, its effect appears (48-72 hours) after injection, it can be repeated within 2 weeks after the first injection as a booster dose. Video-assisted thoracic surgery sympathectomy: mainly used after failure of other methods, we do T3 and T4 bilateral sympathectomy but it has complications. Aim and objectives: to compare between intradermal botulinum neurotoxin injection and thoracoscopic sympathectomy in order to cure primary palmar hyperhidrosis in pediatric population according to complications, compliance, and outcome. Subjects and methods: This was a prospective interventional comparative research was performed at Department of Plastic Surgery and Burns, Faculty of Medicine –Al-Azhar University on thirty individuals who were diagnosed with primary palmer hyperhidrosis divided into two groups. Results: there was a statistically significant difference among the examined groups concerning operative time HDSS data except at the baseline and 4wk. there was no statistically significant difference amongst the examined groups concerning demographic data, Hyperhidrosis presentations, objective type preoperative and postoperative data except objective type. Conclusion: Endoscopic thoracic sympathectomy (ETS) provider superiority over Intradermal Botulinum Neurotoxin Injection (IBI) in treatment of primary Hyperhidrosis in younger patients and in severe cases as a last line of treatment.

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