Treatment of Frey's syndrome with botulinum toxin type B.
OBJECTIVE
Frey's syndrome is a frequent sequela of parotidectomy, causing facial sweating and flushing because of gustatory stimuli. Although botulinum toxin type A has become first-line therapy for Frey's syndrome, some patients become resistant. In this study, we investigated whether another serotype, botulinum toxin type B, might be an effective alternative.


METHODS
Case series with planned data collection.


METHODS
Otolaryngology department in a university hospital.


METHODS
Seven patients aged 30 to 68 years, with severe Frey's syndrome, underwent the Minor test and had 80 U of botulinum toxin type B per cm(2) (mean total dose, 2354 U) injected intracutaneously in the mapped area of gustatory sweating. All patients were followed up for 12 months.


RESULTS
One month after treatment, six of the seven patients reported that gustatory sweating and flushing had resolved, and, in the remaining patient, these symptoms had decreased. The Minor test confirmed a significant improvement. The subjective benefits remained stable for six months in four patients and for nine months in the remaining three patients; 12 months after treatment, all patients still reported some improvement.


CONCLUSIONS
Botulinum toxin type B afforded symptomatic relief in a small sample of patients with Frey's syndrome and might be considered a potential alternative to botulinum toxin type A.
Cantarella
Giovanna
G
Department of Otolaryngology, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Milan, Italy. giovanna.cantarella@policlinico.mi.it
Berlusconi
Alessandra
A
Mele
Vincenzo
V
Cogiamanian
Filippo
F
Barbieri
Sergio
S
D000328:Adult; D000368:Aged; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A; D005260:Female; D006801:Humans; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D010306:Parotid Gland / Q000601:surgery; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013547:Sweating, Gustatory / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
D018726:Anti-Dyskinesia Agents; C096323:rimabotulinumtoxinB; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A