This section describes efficacy outcomes from the published literature that the Committee considered as part of the evidence about this procedure. For more detailed information on the evidence, see the interventional procedure overview.
4.1 In a case series of 831 patients with facial blushing who had endoscopic thoracic sympathectomy (ETS), mean symptom improvement score (assessed on a visual analogue scale; scores from 0 to 10, with 10 indicating worst possible symptoms) decreased from 9 before the procedure to 3 after the procedure in patients with facial blushing at a mean follow-up of 29 months; this difference was significant (p<0.0001).
4.2 A case series of 80 patients (12 patients with isolated facial blushing) reported complete resolution in 33% (4/12) of patients with isolated facial blushing at a mean follow-up of 20 months.
4.3 A case series of 180 patients with isolated facial blushing reported symptom recurrence (1 month to 1 year after the procedure) in 2% (4/173) of patients; all patients subsequently underwent reoperation with 'good results'.
4.4 In the case series of 80 patients (59 patients with facial blushing, isolated or in association with hyperhidrosis) quality of life (assessed on a 5-point Likert scale) was reported to be 'much better' in 63% (37/59) of patients, and there was 'some improvement' in 15% (9/59) of patients and 'no change' in 8% (5/59) of patients.
4.5 A case series of 1700 patients (648 patients with blushing or blushing with hyperhidrosis) reported satisfaction rates of 74% in patients with facial blushing (n=536) at a mean follow-up of 15 years (absolute number not reported). In a case series of 1152 patients, 85% of the 244 patients with facial blushing reported being 'totally satisfied' at a mean follow-up of 8 months (absolute number not reported).
4.6 The specialist advisers stated that key efficacy outcomes were symptom improvement, absence of symptoms and the patient's perception of improvement of symptoms.