Hostname: page-component-6766d58669-vgfm9 Total loading time: 0 Render date: 2026-05-20T11:47:26.242Z Has data issue: false hasContentIssue false
  • English
  • Français

Botulinum toxin for Frey's syndrome: a closer look at different treatment responses

Published online by Cambridge University Press:  03 October 2011

A Steffen ,
N Rotter ,
I R König  and
B Wollenberg
A Steffen*
Affiliation:
Department of Otorhinolaryngology, University of Lübeck, Germany
N Rotter
Affiliation:
Department of Otorhinolaryngology, University of Ulm, Germany
I R König
Affiliation:
Institute of Medical Biometry and Statistics, University of Lübeck, Germany
B Wollenberg
Affiliation:
Department of Otorhinolaryngology, University of Lübeck, Germany
*
Address for correspondence: Dr Armin Steffen, Klinik für HNO-Heilkunde, Ratzeburger Allee 160, 23538 Lübeck, Germany Fax: + 49 451 500 6065 E-mail: armin.steffen@uk-sh.de
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Botulinum toxin is a widely accepted, effective treatment for Frey's syndrome. While some patients need only one injection, others require repeated treatments. We aimed to describe the clinical features of patients with a more challenging treatment course.

Design:

Literature review and retrospective analysis of eight consecutive patients treated at a university hospital.

Subjects:

These patients' treatment responses were categorised (using our own system) and compared with those of 25 published cases.

Results:

Combined analysis identified no significant correlation between treatment response and age, gender or the extent of primary salivary gland surgery. There was no significant correlation between botulinum toxin dosage and time between treatments.

Conclusion:

Frey's syndrome should be viewed as a dynamic process in which the stimulus for aberrant reinnervation of parasympathetic nerve fibres can be reduced, in some patients, with higher botulinum toxin dose injections to the treated areas. However, responses are unpredictable, and relapses may occur at different time points and in different areas.

Keywords

Botulinum ToxinFrey's syndromeSalivary GlandsSweating, Gustatory

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 2 , February 2012 , pp. 185 - 189
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1Matthes, P, Kruegel, J, Karapantzou, C, Winterhoff, J, Laskawi, R. Use of botulinum toxin in ORL departments in Germany [in German]. HNO 2010;58:452–8CrossRefGoogle ScholarPubMed
2Drobik, C, Laskawi, R. Frey's syndrome: treatment with botulinum toxin [in German]. HNO Aktuell 1994;2:142–4Google Scholar
3Drobik, C, Laskawi, R. Frey's syndrome: treatment with botulinum toxin. Acta Otolaryngol (Stockh) 1995;115:459–61CrossRefGoogle ScholarPubMed
4Clayman, MA, Clayman, SM, Seagle, MB. Review of the surgical and medical treatment of Frey syndrome. Ann Plast Surg 2006;57:581–4CrossRefGoogle ScholarPubMed
5Minor, V. A new method to the clinical examination of sweating [in German]. Dtsch Nervenheilk 1928;101:302–8CrossRefGoogle Scholar
6Wang, CC, Wang, CP. Preliminary experience with botulinum toxin type A intracutaneous injection for Frey's syndrome. J Chin Med Assoc 2005;68:463–7CrossRefGoogle ScholarPubMed
7Laccourreye, O, Akl, E, Gutierrez-Fonseca, R, Garcia, D, Brasnu, D, Bonan, B. Recurrent gustatory sweating (Frey syndrome) after intracutaneous injection of botulinum toxin type A: incidence, management, and outcome. Arch Otolaryngol Head Neck Surg 1999;125:283–6CrossRefGoogle ScholarPubMed
8Bakke, M, Thorsen, NM, Bardow, A, Dalager, T, Thomsen, CE, Reguer, L. Treatment of gustatory sweating with low-dose botulinum toxin A. Acta Odontol Scand 2006;64:129–33CrossRefGoogle ScholarPubMed
9Pornprasit, M, Chintrakarn, C. Treatment of Frey's syndrome with botulinum toxin. J Med Assoc Thai 2007;90:2397–402Google Scholar
10Capaccio, P, Torretta, S, Osio, M, Minorati, D, Ottaviani, F, Sambataro, G et al. Botulinum toxin therapy: a tempting tool in the management of salivary secretory disorders. Am J Otolaryngol 2008;29:333–8CrossRefGoogle ScholarPubMed
11Laccourreye, O, Muscatelo, L, Naude, C, Bonan, B, Brasnu, D. Botulinum toxin type A for Frey's syndrome: a preliminary prospective study. Ann Otol Rhinol Laryngol 1998;107:52–5CrossRefGoogle ScholarPubMed
12Blitzer, A, Sulica, L. Botulinum toxin: basic science and clinical uses in otolaryngology. Laryngoscope 2001;111:218–26CrossRefGoogle ScholarPubMed
13Laskawi, R, Drobik, C, Schonebeck, C. Up-to-date report of botulinum type A treatment in patients with gustatory sweating (Frey's syndrome). Laryngoscope 1998;108:381–4CrossRefGoogle ScholarPubMed
14Hartl, DM, Julieron, M, LeRidant, AM, Janot, F, Marandas, P, Travagli, JP. Botulinum toxin A for quality of life improvement in post-parotidectomy gustatory sweating (Frey's syndrome). J Laryngol Otol 2008;122:1100–4CrossRefGoogle ScholarPubMed
15Laskawi, R, Ellies, M, Rödel, R, Schoenebeck, C. Gustatory sweating: clinical implications and etiologic aspects. J Oral Maxillofac Surg 1999;57:642–8CrossRefGoogle ScholarPubMed
16Nolte, D, Gollmitzer, I, Loeffelbein, DJ, Hölzle, F, Wolff, KD. Botulinum toxin for treatment of gustatory sweating. A prospective randomized study. Mund Kiefer Gesichtschir 2004;8:369–75CrossRefGoogle ScholarPubMed
17Guntinas-Lichius, O. Increased botulinum toxin type A dosage is more effective in patients with Frey's syndrome. Laryngoscope 2002;112:746–9CrossRefGoogle ScholarPubMed
18Cantarella, G, Berlusconi, A, Mele, V, Cogiamanian, F, Barbieri, S. Treatment of Frey's syndrome with botulinum toxin type B. Otolaryngol Head Neck Surg 2010;143:214–18CrossRefGoogle ScholarPubMed
19de Bree, R, Duyndam, JE, Kuik, DJ, Leemans, R. Repeated botulinum toxin type A injections to treat patients with Frey's syndrome. Arch Otolaryngol Head Neck Surg 2009;135:287–90CrossRefGoogle Scholar
20Martos Díaz, P, Bances del Castillo, R, Mancha de la Plata, M, Naval Gías, L, Martínez Nieto, C, Lee, GY et al. Clinical results in the management of Frey's syndrome with injections of botulinum toxin. Med Oral Patol Oral Cir Bucal 2008;13:E248–52Google ScholarPubMed
21Luna Ortiz, K, Rascon Ortiz, M, Sanson Riofrio, JA, Villavicencio Valencia, V, Mosqueda Taylor, A. Control of Frey's syndrome in patients treated with botulinum toxin type A. Med Oral Patol Oral Cir Bucal 2007;12:E79–84Google ScholarPubMed