ETS Side Effects, Complications
Patients should be aware that compensatory sweating
can and does occur.
Compensatory sweating is experienced as excessive sweating on the back, thighs,
stomach, axillae, groin and/or lower legs and may range from mild to severe.
Reported incidence of developing compensatory sweating in world literature range
between 50% to 90% of all patients undergoing the ETS procedure. Of this group,
it has been reported that about 5% - 10% of these patients experience severe
compensatory sweating. Severe compensatory sweating, or severe compensatory hyperhidrosis,
can be very troublesome, especially when it soaks through clothing. This can
be more problematic in hot humid climates and can become more of a problem than
the original problem treated.
The tolerance of compensatory sweating is patient dependent. Some patients tolerate
severe sweating while others do not tolerate even mild compensatory sweating.
There are medications that may help lessen the severity of compensatory sweating
Overweight patients may experience more compensatory sweating and those who live
in hot, humid climates may find it less tolerable. Compensatory sweating is the
most common side effect reported by patients regardless of which surgeon is performing
Gustatory Sweating, which occurs while eating or smelling certain foods, can
develop post operatively in about 10 to 20% of the patients.
Phantom sweating occurs in some patients after ETS surgery (feeling the sensations
of sweating but not actually sweating) and typically resolves in 1 to 3 weeks
Serious complications from the surgery
Sensitive pleurae (chest lining sensitivity)
can limit exercise, Horners Syndrome, which is rarely reported,
pneumothorax (collapsed lung), bleeding, postop neuralgia and
parasthesias, possible hair loss, and bradycardia (slow heart
rate) possibly requiring a pacemaker. Other possible complications
include, but are not limited to, subcutaneous emphysema, possible
conversion to open thoracotomy and heat intolerance.
Possible persistence of symptoms can occur if accessory nerve
branches are present, duplicate nerve or aberrant nerve tracts
are present. Recurrence of symptoms can occur if nerve regeneration
occurs (unusual), which could necessitate a need for a redo
Death has been reported in some ETS patients in the world literature.