[Severe Frey syndrome after parotidectomy: treatment with botulinum neurotoxin type A].

Abstract

Based upon an inception cohort of 30 patients with severe Frey's syndrome, after conservative parotidectomy, the technique and the results of intracutaneous injection of botulinum toxin type A are presented. The skin surface involved with Frey's syndrome was managed with intracutaneous injection of 2.5 international units of botulinum toxin type A per square centimeter. A minimum follow-up of 16 months was achieved. The only adverse side effect encountered was a temporary paresis of the upper lid noted in 2 patients. Frey's syndrome vanished within 2-5 days from the intracutaneous injection of botulinum toxin type A. Frey's syndrome was controlled in 53.2% of cases (17/30) after the initial injection of botulinum toxin type A. Five of the 13 patients with recurrence of Frey's syndrome elicited to undergo a watch and wait policy due to the lack of discomfort induced by the recurrence. The remaining eight patients with recurrence of Frey's syndrome were successfully managed with a secondary intracutaneous injection of botulinum toxin type A. Such preliminary data, together with the review of the literature suggests, that the intracutaneous injection of botulinum toxin type A should now be the first line treatment option in patients with severe Frey syndrome.

• Authors: O Laccourreye, L Muscatello, R Gutierrez-Fonseca, S Seckin, D Brasnu, B Bonan
• Journal: Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Societe d'oto-laryngologie des hopitaux de Paris (Ann Otolaryngol Chir Cervicofac) Vol. 116 Issue 3 Pg. 137-42 (Jun 1999) ISSN: 0003-438X [Print] France
• Vernacular Title: Syndrome de Frey sévère post-parotidectomie: traitement par la neuro-toxine botulique de type A.
• PMID: 10399528 (Publication Type: English Abstract, Journal Article)

Chemical References

• Neuromuscular Agents
• Botulinum Toxins, Type A

Topics

• Adolescent
• Adult
• Aged
• Botulinum Toxins, Type A (therapeutic use)
• Cohort Studies
• Female
• Humans
• Male
• Middle Aged
• Neuromuscular Agents (therapeutic use)
• Parotid Gland (surgery)
• Postoperative Complications (diagnosis, drug therapy)
• Severity of Illness Index
• Sweating, Gustatory (diagnosis, drug therapy)