Basically, by apllying the botox, they extend the sympathectomy to a further level. What would be very interesting to find out is whether or not the botox wears of in a while for everyone, like it usually does in HH. That way, people with HH could find out what ETS would do for them without it being permanent.
That's really what's my main objection is with ETS. That the results could potentially be very negative and would then be permanent and secondly that, while there has been somewhat more energy being put into HH by medics lately, in the end a better treatment could come along with less side-effects and then it would suck to have had ETS done.
So the question really for me is, does the botox wear off (the study implies it does) and how long does that take (if it takes too short, insurance companies will try their best not to fork over over the cash to do repeated treatments for sure, if it takes too long I might not want to take the risk...)