1
|
|
2
|
Two-Dimensional Ablation of Apocrine Glands With the Use of Hydrosurgical Treatment of Axillary Osmidrosis: An Analysis of 480 Cases. Ann Plast Surg 2019; 83:137-142. [PMID: 31232825 DOI: 10.1097/sap.0000000000001904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Axillary osmidrosis is a distressing social problem. Topical antiperspirants are only transient solutions. Permanent solutions always need invasive operation. In this study, we evaluated the effectiveness and complications of a minor surgical procedure. From January 2010 to December 2017, 480 patients (376 females and 104 males) whose ages ranged from 8 to 72 years, with an average age of 28 years, were treated for axillary osmidrosis with hydrosurgery (Versajet unit surgical instruments) under local anesthesia on an outpatient basis. Patients were followed for 4 to 80 months with an average of 24 months. The total satisfaction rate was 99.6% (478/480). The patient complication rate was 2.7% (13/480) and the wound complication rate was 1.8% (17/960). There was 2 patient (3 axillae) got recurrent malodor cured with second operation. There were no contracture scars, arm abduction limitation, or any nerve injury in our series. The minor procedure can be an efficient and predictable treatment choice for axillary osmidrosis.
Collapse
|
3
|
Van TN, Manh TN, Minh PPT, Minh TT, Huu ND, Cao KP, Huu QN, Cam VT, Huyen ML, Hau KT, Gandolfi M, Satolli F, Feliciani C, Tirant M, Vojvodic A, Lotti T. The Effectiveness of Local Surgical Technique in Treatment of Axillary Bromhidrosis. Open Access Maced J Med Sci 2019; 7:187-191. [PMID: 30745954 PMCID: PMC6364733 DOI: 10.3889/oamjms.2019.133] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND: Up to now, surgical excision of apocrine glands still has been a method that yields high treatment results and low rate of odour recurrent for patients, but many people worry about some serious complications that have been observed postoperatively, such as hematoma and skin necrosis. These prolong wound healing, leading to unsightly scars in the axillary fossae. AIM: We conducted this research to investigate the effects and complications of our surgical technique for axillary bromhidrosis. METHODS: Forty-three patients with axillary bromhidrosis were treated. An elliptical incision was made at a central portion of the area marked, with both tips of the ellipse along the axillary crease. The elliptical skin with the subcutaneous tissue was removed en lock. The adjacent skin was undermined to the periphery of the hair-bearing area with straight scissors. The undermined subcutaneous tissue was removed with curved scissors, and the skin was defatted to become a full-thickness skin flap. Any suspected hemorrhagic spots were immediately coagulated electrosurgically. Appropriate drains were placed, and the treated area was covered with thick gauze to each axilla. Arm movement was strictly controlled in the first 3 days post-operatively. RESULTS: Thirty-one patients have been followed up and evaluated for 6 months. 56 out of 62 axillae (90.3%) showed good to excellent results for malodor elimination. All patients reported a reduction in axillary sweating. There were two axillae of skin necrosis and three axillae of hematoma, with one patient receiving an anticoagulant from a cardiologist after the first day of surgery, to treat heart valve disease. The Dermatology Life Quality Index (DLQI) score decreased significantly, and the quality of life improved after the operation. CONCLUSION: Our technique is a simple surgical procedure and easy to perform helping to achieve results for high malodor elimination, with almost no serious complications. Patient’s life quality improved significantly after the operation.
Collapse
Affiliation(s)
- Thuong Nguyen Van
- National Hospital of Dermatology and Venereology, Hanoi, Vietnam.,Hanoi Medical Univesity, Vietnam
| | - Tan Nguyen Manh
- National Hospital of Dermatology and Venereology, Hanoi, Vietnam
| | | | - Trang Trinh Minh
- National Hospital of Dermatology and Venereology, Hanoi, Vietnam
| | - Nghi Dinh Huu
- National Hospital of Dermatology and Venereology, Hanoi, Vietnam.,Hanoi Medical Univesity, Vietnam
| | - Kiem Pham Cao
- National Hospital of Dermatology and Venereology, Hanoi, Vietnam
| | - Quang Nguyen Huu
- National Hospital of Dermatology and Venereology, Hanoi, Vietnam
| | - Van Tran Cam
- National Hospital of Dermatology and Venereology, Hanoi, Vietnam
| | - My Le Huyen
- National Hospital of Dermatology and Venereology, Hanoi, Vietnam
| | - Khang Tran Hau
- National Hospital of Dermatology and Venereology, Hanoi, Vietnam.,Hanoi Medical Univesity, Vietnam
| | | | | | | | - Michael Tirant
- University of Rome G. Marconi, Rome Italy.,Psoriasis Eczema Clinic, Melbourne, Australia
| | - Aleksandra Vojvodic
- Department of Dermatology and Venereology, Military Medical Academy of Belgrade, Belgrade, Serbia
| | | |
Collapse
|
4
|
Yang H, Miao Y, Chen Y, Hu Z. Minimally invasive approaches to axillary osmidrosis treatment: A comparison between superficial liposuction with automatic shaver curettage, subcutaneous laser treatment, and microwave‐based therapy with a modified technique. J Cosmet Dermatol 2018; 18:594-601. [PMID: 30203579 DOI: 10.1111/jocd.12731] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 06/27/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Hung‐Hsu Yang
- Department of Plastic and Aesthetic Surgery Nanfang Hospital of Southern Medical University Guangzhou City, Guangdong Province China
- Department of Dermatology, Shuang Ho Hospital Taipei Medical University Taipei Taiwan
| | - Yong Miao
- Department of Plastic and Aesthetic Surgery Nanfang Hospital of Southern Medical University Guangzhou City, Guangdong Province China
| | - Yu‐Tsung Chen
- Department of Dermatology, Shuang Ho Hospital Taipei Medical University Taipei Taiwan
- School of Public Health, College of Public Health and Nutrition Taipei Medical University Taipei Taiwan
| | - Zhi‐Qi Hu
- Department of Plastic and Aesthetic Surgery Nanfang Hospital of Southern Medical University Guangzhou City, Guangdong Province China
| |
Collapse
|
5
|
Han JH, Kim JK, Yoon KC, Shin HW. Versajet-Assisted Hydraulic Epilation Through Small Incisions for Axillary Osmidrosis. Aesthetic Plast Surg 2018; 42:617-624. [PMID: 29464384 PMCID: PMC5945771 DOI: 10.1007/s00266-018-1097-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 01/28/2018] [Indexed: 11/26/2022]
Abstract
Background Osmidrosis is a malodorous disease caused by the breakdown of sweat secreted from the apocrine glands by surface bacteria. The aim of this study was to evaluate the effect of Versajet-assisted hydraulic epilation for the treatment of axillary osmidrosis. Methods Thirty-two patients with axillary osmidrosis (64 axillae) underwent Versajet-assisted hydraulic epilation between January 2016 and January 2017. Subjective assessments were evaluated by a patient survey at least 3 months after the procedure. Results There were no complications other than one mild pigmentation in the axilla at 3 months after the procedure. Thirty-two patients evaluated malodor elimination as good. No patients evaluated it as fair or poor. There were no recurrences. Conclusion Versajet-assisted hydraulic epilation is an ideal surgical procedure for the treatment of axillary osmidrosis that decreases complications and recurrence. No Level Assigned This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Collapse
Affiliation(s)
- Jin Ho Han
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea
| | - June-Kyu Kim
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea.
| | - Kun Chul Yoon
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea
| | - Hyun Woo Shin
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea
| |
Collapse
|
6
|
|
7
|
Chen YT, Shih PY, Chen HJ, Chen TJ. Treatment of axillary osmidrosis: a comparison between subcutaneous laser and superficial liposuction curettage. J Eur Acad Dermatol Venereol 2015; 29:2019-23. [DOI: 10.1111/jdv.13219] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 05/21/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Y.-T. Chen
- Department of Dermatology; Wan Fang Hospital; Taipei Medical University; Taipei Taiwan
- Department of Dermatology; School of Medicine; College of Medicine; Taipei Medical University; Taipei Taiwan
| | - P.-Y. Shih
- Department of Dermatology; Wan Fang Hospital; Taipei Medical University; Taipei Taiwan
- Department of Dermatology; School of Medicine; College of Medicine; Taipei Medical University; Taipei Taiwan
| | - H.-J. Chen
- Department of Urology; Tri-Service General Hospital; Taipei Taiwan
| | - T.-J. Chen
- Department of Dermatology; Wan Fang Hospital; Taipei Medical University; Taipei Taiwan
- Department of Dermatology; School of Medicine; College of Medicine; Taipei Medical University; Taipei Taiwan
| |
Collapse
|
8
|
Semkova K, Gergovska M, Kazandjieva J, Tsankov N. Hyperhidrosis, bromhidrosis, and chromhidrosis: Fold (intertriginous) dermatoses. Clin Dermatol 2015; 33:483-91. [DOI: 10.1016/j.clindermatol.2015.04.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
9
|
Modified tumescent superficial suction with curettage treatment for axillary bromidrosis: clinical experience of 280 cases. Aesthetic Plast Surg 2014; 38:151-155. [PMID: 24337172 DOI: 10.1007/s00266-013-0246-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 11/13/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Axillary bromidrosis adversely affects patients' social and personal life with excessive malodor. Although surgical resection of the apocrine glands is one effective and irreversible method for treating axillary bromidrosis, the postoperation complications cannot be ignored. This study aimed to evaluate the long-term outcome of the authors' modified tumescent superficial suction with a curettage procedure for axillary bromidrosis treatment. METHODS From January 2010 to December 2012, 450 patients with axillary bromidrosis visited the authors' plastic surgery outpatient department and received the modified treated using tumescent superficial suction with a curettage procedure. A total of 170 patients were lost to follow-up evaluation and eliminated from this study. RESULTS The follow-up period ranged from 5 to 35 months (mean 15.5 months). Among 280 patients, 261 (93.2 %) showed excellent to good results. Reoperation with the same procedure was performed for 15 patients, and all had excellent results afterward. The most common postoperative complication was transient ecchymosis (23.6 %). CONCLUSION The modified suction and curettage procedure is an optimal therapeutic strategy for axillary bromidrosis treatment. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Collapse
|
10
|
Treatment of Axillary Osmidrosis Using a Subcutaneous Pulsed Nd-YAG Laser. Arch Plast Surg 2012; 39:143-9. [PMID: 22783514 PMCID: PMC3385321 DOI: 10.5999/aps.2012.39.2.143] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 02/07/2012] [Accepted: 02/22/2012] [Indexed: 11/24/2022] Open
Abstract
Background Axillary osmidrosis is characterized by an unpleasant odor, profuse sweating, and in some instances, staining of clothes that may socially and psychologically impair affected individuals. Various types of surgical procedures have been developed for the treatment of axillary osmidrosis. This study was undertaken to evaluate the effectiveness of subcutaneous pulsed neodymium: yttrium-aluminum-garnet (Nd-YAG) laser treatment for the treatment of axillary osmidrosis. Methods Twenty-nine patients with axillary osmidrosis were included in this study. Patients were categorized according to the results of an axillary malodor grading system, and a subcutaneous pulsed Nd-YAG laser was applied to all patients. The treatment area for the appropriate distribution of laser energy was determined using the iodine starch test (Minor's test) against a grid pattern composed of 2×2 cm squares. The endpoint of exposure was 300 to 500 J for each grid, depending on the preoperative evaluation results. The results were evaluated by measurement of axillary malodor both pre- and postoperatively using the grading system and iodine starch test. Results The average follow-up period was 12.8 months. Nineteen patients had a fair-to-good result and ten patients had poor results. The postoperative Minor's test demonstrated that there were remarkable improvements for patients with mild to moderate symptoms. Complications including superficial second degree burns (n=3) were treated in a conservative manner. A deep second degree burn (n=1) was treated by a surgical procedure. Conclusions Subcutaneous pulsed Nd-YAG laser has many advantages and is an effective noninvasive treatment for mild to moderate axillary osmidrosis.
Collapse
|
11
|
Bechara FG, Georgas D, Sand M, Stücker M, Othlinghaus N, Altmeyer P, Gambichler T. Effects of a long-pulsed 800-nm diode laser on axillary hyperhidrosis: a randomized controlled half-side comparison study. Dermatol Surg 2012; 38:736-40. [PMID: 22273498 DOI: 10.1111/j.1524-4725.2012.02339.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Generally, axillary hyperhidrosis (AH) is treated with antiperspirant agents, botulinum toxin, or local surgery. The effect of laser treatment on sweat secretion in patients with AH has not been investigated. OBJECTIVE To evaluate the effect of diode laser epilation on the sweat rate of patients with AH. MATERIALS AND METHODS We performed a randomized half-side controlled trial. Twenty-one patients were treated with 5 cycles of an 800-nm diode laser. Sweat rates were documented using gravimetry and a visual analogue scale. Histologic examination was performed in all patients before and after treatment. RESULTS A significant reduction in sweat rate was observed on the laser-treated (median 89 mg/min, range 42-208 mg/min vs 48 mg/min, range 17-119 mg/min; p < .001) and the untreated contralateral (median 78 mg/min, range 25-220 mg/min vs median 65 mg/min, range 24-399 mg/min; p = .04) sides, although no significant difference was found between the treated and untreated sides (p = .10). CONCLUSION Although we observed a significant decrease in sweat rate on laser-treated sites, laser epilation was not able to reduce the sweat rate significantly more than on the untreated contralateral side. These results probably indicate a placebo effect rather than a direct therapeutic effect of laser epilation.
Collapse
Affiliation(s)
- Falk G Bechara
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany.
| | | | | | | | | | | | | |
Collapse
|
12
|
Goldman A, Wollina U, de Mundstock EC. Evaluation of Tissue Tightening by the Subdermal Nd: YAG Laser-Assisted Liposuction Versus Liposuction Alone. J Cutan Aesthet Surg 2011; 4:122-8. [PMID: 21976904 PMCID: PMC3183717 DOI: 10.4103/0974-2077.85035] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Skin tightening is a desirable outcome for skin flaccidity. OBJECTIVE We evaluated the applicability, safety, capacity and intensity of skin tightening with the subdermal 1,064 nm Nd: YAG laser application to the upper arms, and compared the results with liposuction. MATERIALS AND METHODS Patients with lipodystrophy and mild-to-severe skin laxity of the arms were included (n=28). In half of patients, a single treatment with a subcutaneous laser and liposuction was performed, while the other 14 had a regular liposuction. Treatment parameters, adverse effects and photographic documentation were recorded. RESULTS Aesthetic improvement and skin retraction was superior by laser lipolysis. The procedure was well tolerated without significant complications. CONCLUSIONS The subdermal laser-assisted liposuction using a 1,064 nm Nd: YAG laser achieves improved skin tightening.
Collapse
|
13
|
Ablation of Apocrine Glands With the Use of a Suction-Assisted Cartilage Shaver for Treatment of Axillary Osmidrosis. Ann Plast Surg 2009; 62:278-83. [DOI: 10.1097/sap.0b013e3181776398] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
14
|
|
15
|
|
16
|
Subdermal Nd-YAG Laser for Axillary Hyperhidrosis. Dermatol Surg 2008. [DOI: 10.1097/00042728-200806000-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
17
|
|
18
|
Ozawa T, Nose K, Harada T, Muraoka M, Ishii M. Treatment of osmidrosis with the Cavitron ultrasonic surgical aspirator. Dermatol Surg 2006; 32:1251-5. [PMID: 17034374 DOI: 10.1111/j.1524-4725.2006.32285.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Axillary osmidrosis is an uncomfortable condition that can be a personal or social handicap. OBJECTIVE The objective was to present the treatment of osmidrosis with the Cavitron ultrasonic surgical aspirator (CUSA). MATERIALS AND METHODS Fifteen patients (3 males and 12 females) underwent surgery for bilateral axillary osmidrosis with the CUSA. RESULTS The outcome of this operation with the CUSA was evaluated by the patients themselves according to the following criteria. Postoperative improvement was evaluated as good when the odor was decreased by >75%, fair when it was decreased by > or =50 and < or =75%, and poor when it was decreased by <50%. A total of 15 patients (3 males and 12 females) were evaluated. Eight patients (53.3%) had a good result, 6 patients (40%) had a fairly good result, and 1 patient (6.7%) had a poor result. None of the patients experienced any complications, such as skin necrosis, infection, or serous cyst. One dissatisfied patient underwent reoperation and achieved a good result after the second procedure. CONCLUSIONS This treatment of osmidrosis with the CUSA achieves satisfactory therapeutic efficacy.
Collapse
Affiliation(s)
- Toshiyuki Ozawa
- Department of Plastic and Reconstructive Surgery, Osaka City University, Graduate School of Medicine, Abeno, Osaka, Japan.
| | | | | | | | | |
Collapse
|
19
|
Treatment of Osmidrosis with the Cavitron Ultrasonic Surgical Aspirator. Dermatol Surg 2006. [DOI: 10.1097/00042728-200610000-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
20
|
Ichikawa K, Miyasaka M, Aikawa Y. Subcutaneous Laser Treatment of Axillary Osmidrosis: A New Technique. Plast Reconstr Surg 2006; 118:170-4. [PMID: 16816691 DOI: 10.1097/01.prs.0000221005.86108.0d] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Kota Ichikawa
- Department of Plastic Surgery, Tokai University School of Medicine, Bohseidai, Isehara-shi, Kanagawa 259-1193, Japan.
| | | | | |
Collapse
|
21
|
Lee D, Cho SH, Kim YC, Park JH, Lee SS, Park SW. Tumescent liposuction with dermal curettage for treatment of axillary osmidrosis and hyperhidrosis. Dermatol Surg 2006; 32:505-11; discussion 511. [PMID: 16681657 DOI: 10.1111/j.1524-4725.2006.32103.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Axillary osmidrosis and hyperhidrosis are distressing social problems, particularly in Asian societies. Various treatment methods have been developed for removal of the apocrine and eccrine glands. But conventional surgical methods often lead to significant scarring and frequent recurrence. OBJECTIVE To evaluate the effect of liposuction with curettage using a new device, the Fatemi cannula, in the treatment of axillary osmidrosis and hyperhidrosis. METHODS From August 2003 through December 2004, 25 patients (15 women and 10 men) with axillary osmidrosis or hyperhidrosis were treated by tumescent liposuction and curettage. The results of malodor elimination were graded by the patients as excellent, good, fair, and poor. Changes in axillary sweating and hair growth, postoperative scarring, patient satisfaction degree, and complications were also evaluated. Biopsies of the axillary skin were performed in 14 patients. RESULTS Of the 50 axillae, 38 (76.0%) were graded as excellent results, 11 (22.0%) were good, and one (2.0%) was fair. No serious complications were noted except temporary ecchymosis and local infection in minor cases. The preoperative histologic examinations showed large and numerous apocrine glands and postoperative significant decrease and degeneration of them. CONCLUSION Tumescent liposuction with dermal curettage using the Fatemi cannula is an effective and safe method in the treatment of axillary osmidrosis and hyperhidrosis.
Collapse
Affiliation(s)
- Deborah Lee
- Department of Dermatology, Busan Paik Foundation Hospital, Inje University Medical College, Busan, Korea
| | | | | | | | | | | |
Collapse
|
22
|
Tumescent Liposuction with Dermal Curettage for Treatment of Axillary Osmidrosis and Hyperhidrosis. Dermatol Surg 2006. [DOI: 10.1097/00042728-200604000-00004] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
23
|
Kao TH, Pan HC, Sun MH, Chang CS, Yang DY, Wang YC. Upper thoracic sympathectomy for axillary osmidrosis or bromidrosis. J Clin Neurosci 2004; 11:719-22. [PMID: 15337132 DOI: 10.1016/j.jocn.2003.11.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2003] [Accepted: 11/07/2003] [Indexed: 10/26/2022]
Abstract
The difference between axillary osmidrosis (AO) and axillary bromidrosis (AB) is the degree of odor and quantity of sweat, which is associated with selection of therapeutic modality theoretically. Upper thoracic sympathectomy has been used for both diseases but its effect needs to be further evaluated with more clinical data. We collected 108 patients with AO or AB treated by upper thoracic sympathectomy from July 1995 to July 2002. Of these patients, 42 suffered AO alone, 17 had AB (AO with axillary hyperhidrosis [AH]), and 49 had AO with palmar hyperhidrosis (PH). Ninety-two patients (183 sides) received anterior subaxillary transthoracic endoscopic sympathectomy (TES) and 17 patients (33 sides) received posterior percutaneous thoracic phenol sympathicolysis (PTPS). The levels of sympathectomy or sympathicolysis were T3-4 for AO and AB, and T2-4 for AO with PH. Mean follow-up period was 45.2 months (13-97 months). The satisfaction rates of patients were 52.4%, 70.6% and 61.2% for AO, AB and AO with PH, respectively. The rates of patients with improvement and satisfaction were 78.6%, 88.2% and 85.7% for AO, AB, and AO with PH, respectively. These results suggest that upper thoracic sympathectomy may be an acceptable treatment for AB or AO with PH rather than AO only.
Collapse
Affiliation(s)
- Ting-Hsien Kao
- Department of Neurosurgery, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | | | | | | | | | | |
Collapse
|
24
|
Abstract
Axillary osmidrosis is a distressing problem, and in severe cases patients may seek a permanent solution. Many treatment techniques have been developed that involve destruction or removal of the apocrine and eccrine glands. Previous methods have been hampered by surgical or aesthetic concerns. From June 1999 to June 2000, 64 patients (43 women and 21 men) were treated surgically for axillary osmidrosis. A 1-cm incision is made in the axillary crease. An endoscopic shaver is inserted, extended to the edge of the axilla, and subcutaneous tissue and glands are excised as the shaver is drawn from the axillary edge to the crease. Suction connected to the shaver immediately removes excised tissue. This procedure is repeated throughout the entire axilla. Malodor elimination was good in 117 of 128 axillae (91.4%) treated, fair in 8 (6.3%), and poor in 3 (2.3%). The resulting scar is small and essentially invisible because it is located in the axillary crease. This technique results in a small, inconspicuous scar; a surgical time of only 40 minutes; patients resuming exercise and daily activities within 5 days of surgery; and high patient satisfaction.
Collapse
Affiliation(s)
- T C Tung
- Celebrity Cosmetic Center, Taipei, Taiwan, ROC
| |
Collapse
|
25
|
|