Background: Hyperhidrosis is a disorder characterized by excessive sweating, predominantly of the hands, axillae, and feet. Patients suffering from severe hyperhidrosis who have not responded well to non-invasive treatments such as botulinum toxin injections or prescription antiperspirants may undergo an endoscopic thoracic sympathectomy (ETS). An ETS involves cauterizing or, more recently, clipping the sympathetic nerves at the T2-T3 vertebral level just lateral to the sympathetic trunk. The procedure generally decreases the amount of sweating in the original problematic area; however, a major side effect is compensatory sweating and increased total body sweating. Patient satisfaction with this procedure has been reported at rates ranging from 29-95%. This paper illustrates a single case of primary hyperhidrosis and discusses the results of ETS therapy at a single institution.

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