[Severe Frey syndrome after parotidectomy: treatment with botulinum neurotoxin type A].
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.
Service d'Oto-rhino-laryngologie et de chirurgie cervico-faciale, Hôpital Laennec, Paris. ollivier.laccourreye@Inc.ap-hop-paris.fr
O
O
Laccourreye
L
L
Muscatello
R
R
Gutierrez-Fonseca
S
S
Seckin
D
D
Brasnu
B
B
Bonan
D000293:Adolescent; D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D010306:Parotid Gland / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000188:drug therapy*; D012720:Severity of Illness Index; D013547:Sweating, Gustatory / Q000175:diagnosis* / Q000188:drug therapy*
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
Syndrome de Frey sévère post-parotidectomie: traitement par la neuro-toxine botulique de type A.