Article

Frey syndrome: treatment with type A botulinum toxin.

Department of Maxillofacial Surgery, University of Bonn, Bonn, Germany.
Cancer (Impact Factor: 4.9). 11/2000; 89(8):1659-63.
Source: PubMed

ABSTRACT Frey syndrome was first described by Baillarger in 1853. Frey provided a detailed analysis and description as "auriculotemporal syndrome" in 1923. According to the literature, even the most recent therapeutic measures described for the treatment of patients with Frey syndrome have little chance of success and a high incidence of side effects. Thus, a type of treatment is desirable that can suppress the symptoms of Frey syndrome and can offer a good success rate, minimum invasiveness, and few side effects.
The experience of the authors and data from the literature confirmed the efficacy of type A botulinum toxin treatment for patients with Frey syndrome up to a maximum observation period of 3 years.
In the current study, seven patients with severe, symptomatic Frey syndrome after parotidectomy were treated successfully with type A botulinum toxin.
The method of local, intracutaneous treatment with type A botulinum toxin for patients with Frey syndrome is effective, virtually side-effect free, and minimally invasive.

0 Followers
 · 
79 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to evaluate the effects of sternocleidomastoid (SCM) muscle flap on preventing Frey’s syndrome by using, Galvanic skin responses (GSR). Fourty-three patients who underwent superficial parotidectomy were randomly divided into two groups and their GSR were recorded. SCM muscle flap was applied over the surgical area only in one group. Six months after the surgery, GSRs were remeasured. In addition, the patients completed a questionnaire regarding their complaints about clinical Frey’s syndrome. Four patients had symptoms of clinical Frey’s syndrome. Postoperative GSR measurements revealed no significant difference between two sides in flap group (p = 0.426) but higher in without flap group (p = 0.003). The patients with clinical Frey syndrome had significantly higher GSR values than the remaining patients. The SCM muscle flap was an effective method in preventing Frey’s syndrome. Moreover, GSR test was highly sensitive and specific for diagnosis.
    Indian Journal of Otolaryngology and Head & Neck Surgery 01/2014; DOI:10.1007/s12070-012-0492-y · 0.05 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction Frey's syndrome is caused by a mechanical irritative lesion of the vegetative fibers from the auriculotemporal nerve. This lesion causes an abnormal regeneration of the post-ganglionic parasympathetic fibers to the receptors sweat gland and blood vessels, causing increases sensitivity, skin erythema and sudation during meals. Methods A literature search was performed in PubMed, using a combination of words (Mesh terms), such as «Frey's syndrome» or «syndrome Auriculotemporal» or «gustatory sweating». Results 262 articles, published between 1974 and 2012, were found. Papers were selected and categorized into several groups after reading their abstracts, to facilitate their analysis and exclude the less relevant to the study. This selection led to the achievement of the objectives of this paper, presenting the most relevant aspects of Frey's syndrome, including neuroanatomy, physiopathology, incidence, etiology, diagnosis, prevention and treatment. Conclusion Among the patients who had parotidectomies only a few mentioned spontaneously symptoms suggestive of Frey's syndrome. Therefore the routine use of preventive procedures must be previously and thoroughly considered since it may mask tumoral relapse in the long term. When treatment is needed, the first choice is, still, the injection of botulinum toxin type A.
    04/2013; 54(2):103–114. DOI:10.1016/j.rpemd.2013.02.002
  • [Show abstract] [Hide abstract]
    ABSTRACT: Botulinumtoxin A ist inzwischen eine bewährte Methode zur Behandlung des gustatorischen Schwitzens (gustatorische Hyperhidrose, Frey-Syndrom). Klare Empfehlungen zur Dosierung dieses Toxins liegen jedoch derzeit noch nicht vor. Das Ziel der vorliegenden prospektiv randomisierten Therapiestudie war es daher, Botulinumtoxin A an einem Patientengut der Klinik für Mund-, Kiefer- und Gesichtschirurgie des Knappschaftskrankenhauses Bochum-Langendreer zu untersuchen. Folgende Kriterien wurden dabei berücksichtigt: die Wirksamkeit, die geeignete Dosis bei maximaler Wirkdauer sowie die Patientenzufriedenheit und unerwünschte Wirkungen.Zwanzig Patienten mit einem ausgeprägten Frey-Syndrom bei Zustand nach Operationen der Ohrspeicheldrüse wurden mit dem Jod-Stärke-Test nach Minor untersucht. Die gustatorischen Hautareale wurden im Anschluss an die intrakutanen Injektionen von Botulinumtoxin A über einen Zeitraum von einem Jahr nachuntersucht. Die Patienten wurden randomisiert zwei verschiedenen Behandlungsgruppen zugeführt: Gruppe I (n=10) erhielt 2 MU/cm2, Gruppe II (n=10) erhielt 3 MU/cm2.Die mittlere sekretorische Fläche in den beiden Patientengruppen lag bei 39±9 bzw. 32±12 cm2. Die einmalige Injektion von 3 MU Botulinumtoxin A führte zu einer nahezu vollständigen Blockade des gustatorischen Schwitzens für den gesamten Beobachtungszeitraum von einem Jahr. In der Patientengruppe, die mit 2 MU Botulinumtoxin A pro cm2 behandelt worden war, zeigten sich 44% der gustatorischen Fläche noch sekretorisch aktiv, sodass diesen Patienten ein zweites Mal Botulinumtoxin A injiziert werden musste.Die intrakutane Injektion von Botulinumtoxin A stellt ein hocheffektives, praktikables und minimalinvasives Verfahren zur Behandlung des Frey-Syndroms dar. In der vorliegenden Studie konnte erstmals gezeigt werden, dass bei einer Dosis von 3 MU/cm2 Botulinumtoxin A eine vollständige und zuverlässige Blockade des gustatorischen Schwitzens für mindestens 12 Monate zu erreichen ist. Diese Dosis kann daher für die Therapie dieses Krankheitsbildes empfohlen werden.
    Mund- Kiefer- und Gesichtschirurgie 01/2004; 8(6).