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Moon J, Park S, Lim S. A Novel High-Speed Resonant Frequency Tracking Method Using Transient Characteristics in a Piezoelectric Transducer. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22176378. [PMID: 36080839 PMCID: PMC9460266 DOI: 10.3390/s22176378] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/15/2022] [Accepted: 08/19/2022] [Indexed: 05/30/2023]
Abstract
When driving the piezoelectric transducer (PT: piezo transducer), which is a key device, it is important for the ultrasonic system (using ultrasonic waves of 20 kHz or higher) to operate at a resonant frequency that can maximize the conversion of mechanical energy (vibration) from electrical energy. The resonant frequency of the PT changes during the actual operation according to the load fluctuations and environmental conditions. Therefore, to maintain a stable output in an ultrasonic system, it is essential to track the resonant frequency in a short time. In particular, fast resonant frequency tracking (RFT: resonant frequency tracking) is an important factor in the medical ultrasonic system, i.e., the system applied in this thesis. The reason is that in the case of a medical ultrasonic system, heat-induced skin necrosis, etc., may cause the procedure to be completed within a short period of time. Therefore, tracking the RFT time for maximum power transfer is an important factor; in this thesis, we propose a new high-speed RFT method. The proposed method finds the whole system resonance frequency by using the transient phenomenon (underdamped response characteristic) that appears in an impedance system, such as an ultrasonic generator, and uses this to derive the mechanical resonance frequency of the PT. To increase the accuracy of the proposed method, parameter fluctuations of the pressure of the PT, the equivalent circuit impedance analysis of the PT, and a MATLAB simulation were performed. Through this, the correlation between the resonance frequency of the ultrasonic system, including the LC filter with nonlinear characteristics and the mechanical resonance frequency of the PT, was analyzed. Based on the analyzed results, a method for tracking the mechanical resonance frequency that can transfer the maximum output to the PT is proposed in this thesis. Experiments show that using the proposed high-speed RFT method, the ultrasonic system can track the mechanical resonance frequency of the PT with high accuracy in a short time.
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Affiliation(s)
| | - Sungjun Park
- Department of Electrical Engineering, University of Chonnam National, Gwangju 61186, Korea
| | - Sangkil Lim
- Department of Automotive Engineering, University of Honam, Gwangju 62399, Korea
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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.
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Modified Suction-Assisted Cartilage Shaver for Axillary Osmidrosis. BIOMED RESEARCH INTERNATIONAL 2019; 2019:7314753. [PMID: 31205944 PMCID: PMC6530155 DOI: 10.1155/2019/7314753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 11/17/2022]
Abstract
Apocrine osmidrosis (AO) is a chronic, recurrent, and disturbing disease characterized by malodorous secretion from apocrine glands. Despite various conservative and nonsurgical treatments, surgical removal of apocrine glands remains the cornerstone for AO treatment. Conventional suction-assisted cartilage shaver is effective; however, there are several risks and complications. Hence, we modified the conventional method to achieve better effectiveness and reduce complications. This paper aims to evaluate the clinical effectiveness and the complications arising from the modified suction-assisted cartilage shaver for AO. Thirty-nine patients (M/F=11/28, average age 26.3 years) received this surgical treatment for AO from 2013 to 2017 in the Department of Dermatology at Kaohsiung Chang Gung Memorial Hospital, Taiwan. A suction-assisted cartilage shaver was introduced for the ultimate removal of the subcutaneous tissue containing the apocrine glands. A 0.5 cm incision was made in the center of the identified elliptical surgical area at each axilla. After defatting, the incision was closed primarily. The defatting skin was anchored to the axillary fascia by using 4-0 sutures without drains. We then evaluated the clinical efficacy and complications. The mean duration of follow-up was 31.8 months (12–68 months). Among patients receiving the modified cartilage shaving for AO, 92.3% achieved excellent-to-good results, 5.1% had acceptable results, and 2.6% had fair results. None of them experienced poor clinical efficacy. There was no skin necrosis, hematoma, nor wound infection after the surgery. There were no recurrences in all these patients 2 years after the surgery. This modified suction-assisted cartilage shaver for AO results in good efficacy, a low complication rate, and a low recurrence rate. The method is superior to the conventional one due to tissue glue-free procedure, greater comfort in postoperative care, minimal wounds, less hematoma, and less skin necrosis. The clinical study registration number of this study is NCT03793374.
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Yang H, Xu G, Huang CL, Xia Y, Wang XW, Chen Q, Wang SJ, Zhang LY, Tan WQ. Effectiveness and Complications of Improved Liposuction-Curettage Through Mini-Incisions for the Treatment of Axillary Osmidrosis. Plast Surg (Oakv) 2018; 25:234-241. [PMID: 29619345 DOI: 10.1177/2292550317728038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Liposuction-curettage (LC) is a popular and effective surgical method for the treatment of axillary bromhidrosis (AB). However, residual malodour and skin necrosis often appear after this type of surgery. We investigated the efficacy and complications of 4 methods of LC. Methods A total of 280 patients with AB comprised the study cohort, of which 228 were followed up. We carried out 4 methods of modified tumescent LC through mini-incisions and provided a questionnaire for evaluation of surgical outcome. Evaluations were malodour elimination, scarring, reduced growth of hair, and complications. Mean follow-up was 15 months. Results The study involved 449 axillae. In patients with LC in the final phase of improvement (programmed and well-organized LC, skin pinching to wrap up the cannula, LC to the skin around 2 surgical incisions, and cotton balls packed in gauze and an elastic set for post-operative management), excellent elimination of malodor was observed in 141 (89.81%) of 157 axillae. Only 4 (2.55%) cases encountered a small area of skin necrosis, and 28 (17.83%) had local damage to the epidermis. Conclusion These data suggest that LC with a final phase of improvement through mini-incisions is effective for AB treatment.
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Affiliation(s)
- Hu Yang
- Department of Hand Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Gang Xu
- Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China.,Department of Plastic Surgery, The First Hospital of Jiaxing City, Jiaxing, Zhejiang Province, People's Republic of China
| | - Chun-Lan Huang
- Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Ying Xia
- Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Xiao-Wei Wang
- Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Qiang Chen
- Department of Hand Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Shou-Jie Wang
- Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Li-Yun Zhang
- Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China
| | - Wei-Qiang Tan
- Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
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Safran T, Gorsky K, Viezel-Mathieu A, Kanevsky J, Gilardino MS. The role of ultrasound technology in plastic surgery. J Plast Reconstr Aesthet Surg 2018; 71:416-424. [DOI: 10.1016/j.bjps.2017.08.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/19/2017] [Accepted: 08/26/2017] [Indexed: 10/18/2022]
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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]
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Hu X, Zhang Y, Miao X, Dou H, Zhang K, Zhou X, Wang T. Endoscopic Surgical Treatment of Bromhidrosis: A Report of 18 Consecutive Patients from 2010 to 2013. J Laparoendosc Adv Surg Tech A 2014; 24:323-7. [PMID: 24654700 DOI: 10.1089/lap.2013.0427] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Xingqian Hu
- Department of General Surgery, Wuxi People's Hospital, Wuxi, Jiangsu Province, China
| | - Ye Zhang
- Department of General Surgery, Wuxi People's Hospital, Wuxi, Jiangsu Province, China
| | - Xiaofei Miao
- Department of General Surgery, Wuxi People's Hospital, Wuxi, Jiangsu Province, China
| | - Huiqiang Dou
- Department of General Surgery, Wuxi People's Hospital, Wuxi, Jiangsu Province, China
| | - Keming Zhang
- Department of General Surgery, Wuxi People's Hospital, Wuxi, Jiangsu Province, China
| | - Xiong Zhou
- Department of General Surgery, Wuxi People's Hospital, Wuxi, Jiangsu Province, China
| | - Tong Wang
- Department of General Surgery, Wuxi People's Hospital, Wuxi, Jiangsu Province, China
- Nanjing Medical University, Nanjing, Jiangsu Province, China
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Ding Z, Zheng J. A comparison of two different sub-dermal trimming techniques for the treatment of axillary osmidrosis. J Plast Reconstr Aesthet Surg 2013; 66:1569-74. [DOI: 10.1016/j.bjps.2013.06.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 06/18/2013] [Accepted: 06/29/2013] [Indexed: 10/26/2022]
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Treatment of axillary osmidrosis with the use of Versajet. J Plast Reconstr Aesthet Surg 2013; 66:e125-8. [DOI: 10.1016/j.bjps.2013.01.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 01/22/2013] [Accepted: 01/27/2013] [Indexed: 11/20/2022]
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Yang J, Jung SW, Ko SH, Park HR. Liposuction with Diode Laser Ablation for Treatment of Axillary Osmidrosis. ARCHIVES OF AESTHETIC PLASTIC SURGERY 2013. [DOI: 10.14730/aaps.2013.19.3.142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jihoon Yang
- Department of Plastic and Reconstructive Surgery, Hallym University Sacred Heart Hospital Hallym University Medical Center, Anyang, Korea
| | - Sung Won Jung
- Department of Plastic and Reconstructive Surgery, Hallym University Sacred Heart Hospital Hallym University Medical Center, Anyang, Korea
| | - Sung Hoon Ko
- Department of Plastic and Reconstructive Surgery, Hallym University Sacred Heart Hospital Hallym University Medical Center, Anyang, Korea
| | - Hye Rim Park
- Department of Pathology, Hallym University Sacred Heart Hospital Hallym University Medical Center, Anyang, Korea
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Huang YH, Yang CH, Chen YH, Chen CH, Lee SH. Reduction in Osmidrosis Using a Suction-Assisted Cartilage Shaver Improves the Quality of Life. Dermatol Surg 2010; 36:1573-7. [DOI: 10.1111/j.1524-4725.2010.01685.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Effectiveness and complications of subdermal excision of apocrine glands in 206 cases with axillary osmidrosis. J Plast Reconstr Aesthet Surg 2010; 63:1003-7. [DOI: 10.1016/j.bjps.2009.05.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2008] [Revised: 03/11/2009] [Accepted: 05/02/2009] [Indexed: 11/17/2022]
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Abstract
Primary focal hyperhidrosis is a disorder of idiopathic excessive sweating that typically affects the axillae, palms, soles, and face. The disorder, which affects up to 2.8% of the US population, is associated with considerable physical, psychosocial, and occupational impairments. Current therapeutic strategies include topical aluminum salts, tap-water iontophoresis, oral anticholinergic agents, local surgical approaches, and sympathectomies. These treatments, however, have been limited by a relatively high incidence of adverse effects and complications. Non-surgical treatment complications are typically transient, whereas those of surgical therapies may be permanent and significant. Recently, considerable evidence suggests that botulinum toxin type A (BTX-A) injections into hyperhidrotic areas can considerably reduce focal sweating in multiple areas without major adverse effects. BTX-A has therefore shown promise as a potential replacement for more invasive treatments after topical aluminum salts have failed. This article reviews the epidemiology, diagnosis, and management of primary focal hyperhidrosis, with an emphasis on recent research evidence supporting the use of BTX-A injections for this indication.
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Affiliation(s)
- Alexander Grunfeld
- Faculty of Medicine, University of Toronto, Women's College Hospital, Toronto, Ontario, Canada
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Commons GW, Lim AF. Treatment of axillary hyperhidrosis/bromidrosis using VASER ultrasound. Aesthetic Plast Surg 2009; 33:312-23. [PMID: 19123021 DOI: 10.1007/s00266-008-9283-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2008] [Accepted: 11/11/2008] [Indexed: 11/26/2022]
Abstract
BACKGROUND Current methods of treatment for axillary hyperhidrosis and/or bromidrosis are palliative (use of topical aluminum chloride or injections of botulinum toxin type A) or surgically based for more permanence (excisional surgery, endoscopic transthoracic sympathectomy, liposuction/curettage). The surgical approaches have mixed effectiveness and incur the risk of significant side effects and complications. METHODS Thirteen patients (3 males, 10 females) with significant axillary hyperhidrosis and/or bromidrosis were recruited, treated with the VASER ultrasound, and followed for 6 months. Preoperative assessment of the impact of hyperhidrosis and/or bromidrosis on lifestyle and the degree of sweat/odor were completed. Postoperative assessment of changes relative to lifestyle and degree of sweat/odor reduction and patient and surgeon satisfaction were completed. RESULTS Eleven of 13 patients had significant reduction in sweat/odor and had no recurrence of significant symptoms at 6 months. Two patients had a reduction in sweat/odor but not to the degree desired by the patients. No significant complications were noted. A simple amplitude and time protocol was established that provides consistent and predictable therapy. The complete procedure takes less than 1 h to treat two axillae using local anesthetic. CONCLUSION The VASER is safe and effective for treatment of axillary hyperhidrosis/bromidrosis. The method is minimally invasive with immediate return to basic activities and only temporary minor restriction of arm movement. At 6 months the treatment appears to be long-lasting, but further follow-up is required for verification of permanence. This method has become the standard of care for the treatment of axillary hyperhidrosis/bromidrosis in the authors' practice.
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Affiliation(s)
- George W Commons
- Stanford University School of Medicine, 1515 El Camino Real, Suite C, Palo Alto, CA 94306, USA.
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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]
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Lee HC, Chen CC, Lee WY, Chuang HU, Kao MC. Axillary hyperhidrosis and osmidrosis treated by ultrasonic surgical aspiration compared with transthoracic endoscopic sympathectomy. ACTA ACUST UNITED AC 2008; 70 Suppl 1:S1:64-8. [PMID: 19061771 DOI: 10.1016/j.surneu.2008.08.077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2008] [Accepted: 08/27/2008] [Indexed: 11/28/2022]
Abstract
BACKGROUND Axillary hyperhidrosis (AH) and/or osmidrosis (AO) are characterized by excessive sweating and/or malodor that originate from axillary sweat glands. The condition often causes emotional, social, and professional embarrassment. Although there have been various therapeutic modalities, none has proved entirely satisfactory. In this report, we compared the results of 2 minimally invasive therapeutic modalities (transthoracic endoscopic sympathectomy [TES] and ultrasonic surgical aspiration [USA]) in terms of efficacy and complications and demonstrated which is the better choice of treatment of AH and AO. METHODS In the past years, we have treated patients of AH and/or AO with TES by electrocoagulation of T2 and T3 segment of the thoracic sympathetic trunk. On the other hand, we treated patients with AH and/or AO by using USA with endoscopic confirmation for adequate removal of axillary secretion glands and subcutaneous fat. RESULTS During the past 7 years, 20 patients with AH and/or AO were treated with TES, in which AH obtained adequate relief but AO with only partial alleviation. Only 2 patients showed clinical significant recurrence in 2 years' follow-up. About one half of the patients were complicated with compensatory hyperhidrosis. From May 2005 to April 2006, 55 patients with AO and/or AH were treated with USA. Most patients (91%) obtained adequate relief of AH and AO with minimal wound complications. In the 1-year follow-up, no clinical recurrence was encountered except 2 patients who belonged to the early series of this study. CONCLUSION Based on our clinical experience with the 2 therapeutic techniques (TES and USA), USA is direct removal of local target tissue (secretion glands) and can avoid major wound complications. It has been proven that USA is more logical and effective than TES, which is less effective and often complicated with unwanted compensatory hyperhidrosis. Ultrasonic surgical aspiration aided with endoscopic confirmation is a minimally invasive technique and is considered as the treatment of choice for AO and/or AH.
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Affiliation(s)
- Han-Chung Lee
- Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan, ROC
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Kim WO, Song Y, Kil HK, Yoon KB, Yoon DM. Suction-curettage with combination of two different cannulae in the treatment of axillary osmidrosis and hyperhidrosis. J Eur Acad Dermatol Venereol 2008; 22:1083-8. [DOI: 10.1111/j.1468-3083.2008.02717.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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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.
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Affiliation(s)
- Toshiyuki Ozawa
- Department of Plastic and Reconstructive Surgery, Osaka City University, Graduate School of Medicine, Abeno, Osaka, Japan.
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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]
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Qian JG, Wang XJ. Radical treatment of axillary osmidrosis by subdermal excision of apocrine glands: a prospective study in 31 cases. J Plast Reconstr Aesthet Surg 2006; 59:860-4. [PMID: 16876085 DOI: 10.1016/j.bjps.2005.10.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2005] [Accepted: 10/16/2005] [Indexed: 11/17/2022]
Abstract
Axillary osmidrosis is a troublesome and distressing problem. Medical treatment is only temporally effective. From March 2003 to November 2004, 36 patients with axillary osmidrosis (nine cases combined with axillary hyperhidrosis) have been treated by excision of the subcutaneous glands via a small transverse incision, of which 31 cases could be followed up for a minimum of 3 months (average 7.3 months). In terms of malodour elimination, 30 cases had good results, one had fair result, and none had a poor result. All patients reported significant reducing of sweating, especially those with hyperhidrosis. Postoperative complications were minor, including small haematoma (one axillae), small seroma (two axillae), and superficial epidermal necrosis (21 axillae) which were all spontaneously healed within a week. Twenty-nine (93.5%) patients were very satisfied with the procedure and two (6.5%) patients satisfied, with none regretful. The operation has the advantage of a high success rate in radical elimination of the malodour with minor complications.
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Affiliation(s)
- J G Qian
- Department of Plastic Surgery, Zhejiang Provincial Tongde Hospital, 234 Gucui Road, Hangzhou 310012, China.
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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.
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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.
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Affiliation(s)
- Deborah Lee
- Department of Dermatology, Busan Paik Foundation Hospital, Inje University Medical College, Busan, Korea
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Yoo WM, Pae NS, Lee SJ, Roh TS, Chung S, Tark KC. Endoscopy-assisted ultrasonic surgical aspiration of axillary osmidrosis: a retrospective review of 896 consecutive patients from 1998 to 2004. J Plast Reconstr Aesthet Surg 2006; 59:978-82. [PMID: 16920592 DOI: 10.1016/j.bjps.2005.12.046] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2005] [Revised: 11/21/2005] [Accepted: 12/09/2005] [Indexed: 10/24/2022]
Abstract
Axillary osmidrosis is a distressing and troublesome problem that causes a serious handicap in personal and social life. Many different methods have been introduced to treat axillary osmidrosis, however, they are often accompanied by marked complications. We analysed our experiences using endoscopy-assisted ultrasonic surgical aspiration in treating the axillary osmidrosis. From June 1998 to February 2004, a total of 896 patients (562 females, 334 males) were treated for axillary osmidrosis using endoscopy-assisted ultrasonic surgical aspiration. Our method was satisfactory in 815 patients (91%) and recurrence of odour occurred only in 29 (3.2%) patients. It also showed complications in 28 (3.1%) patients. Our method leaves a small inconspicuous scar and no contracture of the axillary skin after a short and comfortable recovery period and maintains normal axillary hair growth patterns. Axillary osmidrosis can be best treated by endoscopy-assisted ultrasonic surgical aspiration and this operation has many advantages with a high success rate, a low complication rate, and a rapid recovery period.
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Affiliation(s)
- W M Yoo
- Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
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27
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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]
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28
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Lee JC, Kuo HW, Chen CH, Juan WH, Hong HS, Yang CH. Treatment for axillary osmidrosis with suction-assisted cartilage shaver. ACTA ACUST UNITED AC 2005; 58:223-7. [PMID: 15710118 DOI: 10.1016/j.bjps.2004.07.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2004] [Accepted: 07/16/2004] [Indexed: 11/29/2022]
Abstract
Axillary osmidrosis is a common and distressing social problem for many. Topical astringents are temporary and inadequate. Permanent solutions often involve invasive surgical treatment. This study is to evaluate the effectiveness and advantages of treating axillary osmidrosis with suction-assisted cartilage shaver. Eighty-nine patients with osmidrosis were treated with suction-assisted cartilage shaver under local anesthesia on an outpatient basis. Patients were followed-up and surveyed for satisfaction with surgery by completing a questionnaire. Of the 89 patients, 82 patients (92.1%) expressed positive satisfaction with the procedure. In the elimination of odour, a total of 81 patients (91.0%) ranked good to excellent, and seven patients (7.9%) expressed fair results. All of the 89 patients (100%) detected the clearing of wound induration within 3 months. Eighty patients (89.9%) felt their arms were back in full range of movement within 1 month, and all had such hindrance resolved within 2 months. Thus, the procedure proved itself a promising treatment for the removal of sweat glands with advantages of a short operation time, inconspicuous scar, and a rapid recovery for returning to daily activities.
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Affiliation(s)
- Jennifer C Lee
- Department of Dermatology, Chang Gung Memorial Hospital, 199 Tung-Hwa North Road, Taipei, Taiwan
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29
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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.
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Affiliation(s)
- Ting-Hsien Kao
- Department of Neurosurgery, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
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30
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Perng CK, Yeh FL, Ma H, Lin JT, Hwang CH, Shen BH, Chen CH, Fang RH. Is the Treatment of Axillary Osmidrosis with Liposuction Better than Open Surgery? Plast Reconstr Surg 2004; 114:93-7. [PMID: 15220575 DOI: 10.1097/01.prs.0000127801.15386.99] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Axillary osmidrosis is an annoying, although not life-threatening, problem that includes unpleasant odor and the occasional staining of clothing. Suction-assisted lipectomy has been tested as a treatment for axillary osmidrosis with variable success. The authors retrospectively reviewed 134 patients who underwent superficial liposuction for bilateral axillary osmidrosis in their division between June of 1998 and June of 2002. The surgical complications and results were compared with those reported in their previous report of 343 patients (102 available for postoperative result evaluation) who received open surgical treatment with partial excision of axillary skin and subcutaneous tissue. The overall complication rate was 3.73 percent, significantly lower than the 11.08 percent complication rate seen with open surgical treatment. Of their 134 patients, 114 were available for long-term follow-up. Thirteen patients (11.40 percent) had very good results, 79 patients (69.30 percent) had good results, and 22 patients (19.30 percent) had poor results. Significant differences were found between those who underwent superficial liposuction and those who underwent open surgery. The number of patients with very good and good results decreased significantly from 91.18 percent (open surgery) to 80.70 percent (liposuction), and those with little or no improvement increased from 8.82 percent (open surgery) to 19.29 percent (liposuction). Compared with open surgery for the treatment of osmidrosis, liposuction produces significantly fewer complications but is less effective. Of the patients who underwent liposuction for osmidrosis, 80 percent were satisfied with the result. Further study is needed to determine whether liposuction for osmidrosis can be improved.
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Affiliation(s)
- Cherng-Kang Perng
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Veterans General Hospital-Taipei, National Yang-Ming University, Taipei, Taiwan.
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31
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Hong JP, Shin HW, Yoo SC, Chang H, Park SH, Koh KS, Hur JY, Lee TJ. Ultrasound-Assisted Lipoplasty Treatment for Axillary Bromidrosis:. Plast Reconstr Surg 2004; 113:1264-9. [PMID: 15083032 DOI: 10.1097/01.prs.0000110208.28116.3d] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Bromidrosis is a condition of abnormal offensive body odor caused mostly by apocrine gland secretion from the axilla. Although no morbid sequelae are known, the odor can be disturbing enough to cause social impairment and psychological distress. Medical care is available but is temporary and yields limited clinical benefit. Surgical treatment may provide a more definite remedy through reduction of the apocrine gland. However, there are risks for complication following surgical treatment such as subdermal excision, subcutaneous shaving, en bloc excision, and liposuction. The search for a less invasive but still effective procedure has led the authors to use ultrasound-assisted liposuction, which has reduced the risk of complication and recurrence. The purpose of this article was to evaluate the long-term outcome of ultrasound-assisted liposuction for the treatment of bromidrosis. From August 1998 to September 2002, 375 consecutive patients underwent ultrasound-assisted liposuction for bromidrosis of the axilla. The average age of the patients was 25.7 years (range, 15 to 55 years) and the average follow-up period was 18.8 months (range, 7 to 56 months). Subjective complaints of recurrences were noted in 22 patients (5.9 percent) and secondary ultrasound-assisted liposuction was performed, resulting in no further complaints. Complications other than recurrences were mild skin sloughing (3.2 percent), hematoma (1.3 percent), subcutaneous band (0.3 percent), and hypesthesia of the hand (0.3 percent), all of which healed spontaneously. Through a questionnaire that was answered by 264 patients, a subjective satisfaction rate was measured. Among the completed questionnaires, 91.7 percent reported satisfactory reduction of odor. Ultrasound-assisted liposuction to treat bromidrosis of the axilla provides advantages such as rapid recovery, less restriction of movement, unnoticeable scars, and a low rate of recurrence. The long-term outcome supports the benefits of this procedure. The authors recommend the use of ultrasound-assisted liposuction as first-line treatment for bromidrosis of the axilla.
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Affiliation(s)
- Joon Pio Hong
- Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, and Young and Young Plastic Surgery Clinic, Seoul, Korea.
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Fan YM, Wu ZH, Li SF, Chen QX. Axillary osmidrosis treated by partial removal of the skin and subcutaneous tissue en bloc and apocrine gland subcision. Int J Dermatol 2001; 40:714-6. [PMID: 11737439 DOI: 10.1046/j.1365-4362.2001.01291.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Axillary osmidrosis can be treated with many methods, but local surgery is the treatment of choice. METHODS Forty-three patients (32 females and 11 males, average age 20.3 years) were treated by partial removal of the skin and subcutaneous tissue en bloc and follicular clipping of the adjacent area. All operations were performed with local anesthesia in an outpatient setting. RESULTS Follow-up ranged from 2 to 47 months (mean: 13.4 months). Forty-one patients (95%) had good results, two (5%) were fair, and none were poor. No recurrences were seen. The wound complication rate was 3.5% for axillae and 7% for patients. There were no scar contractures or limitations of arm abduction. CONCLUSION This combined surgical method can eliminate malodor and has a low wound complication and recurrence rate. Though the transient and conspicuous scar is the chief drawback of this method, it is a simple, safe, effective and inexpensive method for treating axillary osmidrosis.
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Affiliation(s)
- Y M Fan
- Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, China.
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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.
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Affiliation(s)
- T C Tung
- Celebrity Cosmetic Center, Taipei, Taiwan, ROC
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