Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-27T10:55:17.587Z Has data issue: false hasContentIssue false
  • English
  • Français

Botulinum toxin A for quality of life improvement in post-parotidectomy gustatory sweating (Frey's syndrome)

Published online by Cambridge University Press:  21 February 2008

D M Hartl ,
M Julieron ,
A-M LeRidant ,
F Janot ,
P Marandas  and
J-P Travagli
D M Hartl*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
M Julieron
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
A-M LeRidant
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
F Janot
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
P Marandas
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
J-P Travagli
Affiliation:
Department of General Surgery, Institut Gustave Roussy, Villejuif, France
*
Address for correspondence: Dr Dana M Hartl, Otolaryngology and Head and Neck Surgery, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France. Fax: +33 1 4211 5273 E-mail: dana.hartl@igr.fr
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To measure patient-reported quality of life before and after botulinum toxin A treatment of post-parotidectomy Frey's syndrome (gustatory sweating).

Patients and methods:

A questionnaire concerning functional, social and emotional aspects of Frey's syndrome (14 questions, with responses on a zero to three point scale) was administered to 17 patients (13 women and four men) before and one month after intradermal injection of botulinum toxin A. Parotidectomy had been performed one to 19 years previously, for benign (n = 10) or malignant (n = 7) tumours, with gustatory sweating occurring a median of 15 months after surgery (range: one month to 14 years). Pre- and post-treatment quality of life scores were compared using Wilcoxon's test (p < 0.05).

Results:

Patients' reported functional quality of life improved significantly (p = 0.0004). Their social and emotional scores were not significantly modified (p = 0.155 and 0.142, respectively). Seven patients (41 per cent) found the injections painful, but all patients said that the effects were beneficial, that they would undergo new injections if necessary and that they would recommend this treatment to other patients. The benefit lasted over 1.5 years for 60 per cent of patients. No correlation was found between duration of the effect and the extent of parotidectomy (p = 0.067).

Conclusions:

Botulinum toxin A significantly improved patients' functional quality of life, without significant improvement in their social or emotional quality of life, according to our questionnaire results. The duration of the effect was longer than the reported physiological effect of botulinum toxin A on acetylcholine receptors.

Keywords

Botulinum ToxinGustatory SweatingFrey's SyndromeParotidectomyQuality Of Life
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 10 , October 2008 , pp. 1100 - 1104
Copyright
Copyright © JLO (1984) Limited 2008

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.)

References

1 Frey, L. The auriculotemporalis nerve syndrome [in French]. Rev Neurol 1923;2:97–104Google Scholar
2 Moltrecht, M, Michel, O. The woman behind Frey's syndrome: the tragic life of Lucja Frey. Laryngoscope 2004;114:2205–9CrossRefGoogle ScholarPubMed
3 Guntinas-Lichius, O, Kick, C, Klussmann, JP, Jungehuelsing, M, Stennert, E. Pleomorphic adenoma of the parotid gland: a 13-year experience of consequent management by lateral or total parotidectomy. Eur Arch Otorhinolaryngol 2004;261:143–6CrossRefGoogle ScholarPubMed
4 Dizon, MV, Fischer, G, Jopp-McKay, A, Treadwell, PW, Paller, AS. Localized facial flushing in infancy. Auriculotemporal nerve (Frey) syndrome. Arch Dermatol 1997;133:1143–5CrossRefGoogle ScholarPubMed
5 Blitzer, A, Sulica, L. Botulinum toxin: basic science and clinical uses in otolaryngology. Laryngoscope 2001;111:218–26CrossRefGoogle ScholarPubMed
6 Ranoux, D, Gury, C, Fondarai, J, Mas, JL, Zuber, M. Respective potencies of Botox and Dysport: a double-blind, randomised, crossover study in cervical dystonia. J Neurol Neurosurg Psychiatry 2002;72:459–62Google ScholarPubMed
7 Blitzer, A, Brin, MR, Stewart, CF. Botulinum toxin management of spasmodic dysphonia (laryngeal dystonia): a 12-year experience in more than 900 patients. Laryngoscope 1998;108:1435–41CrossRefGoogle ScholarPubMed
8 Lovice, D. Botulinum toxin use in facial plastic surgery. Otolaryngol Clin North Am 2002;35:171–86CrossRefGoogle ScholarPubMed
9 Shaw, GY, Searl, JP. Botulinum toxin treatment for cricopharyngeal dysfunction. Dysphagia 2001;16:161–7CrossRefGoogle ScholarPubMed
10 Alberty, J, Oelerich, M, Ludwig, K, Hartmann, S, Stoll, W. Efficacy of botulinum toxin A for treatment of upper esophageal sphincter dysfunction. Laryngoscope 2000;110:1151–6CrossRefGoogle ScholarPubMed
11 Suskind, DL, Tilton, A. Clinical study of botulinum toxin-A in the treatment of sialorrhea in children with cerebral palsy. Laryngoscope 2002;112:73–81CrossRefGoogle ScholarPubMed
12 Jongerius, PH, Joosten, F, Hoogen, FJA, Gabreels, FJM, Rotteveel, JJ. The treatment of drooling by ultrasound-guided intraglandular injections of botulinum toxin type A into the salivary glands. Laryngoscope 2003;113:107–11CrossRefGoogle ScholarPubMed
13 Drobik, C, Laskawi, R. Frey's syndrome: treatment with botulinum toxin. Acta Otolaryngol (Stockh) 1995;115:459–61CrossRefGoogle ScholarPubMed
14 Malatskey, S, Rabinovich, I, Fradis, M, Peled, M. Frey syndrome – a delayed clinical onset: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94:338–40CrossRefGoogle ScholarPubMed
15 Nolte, D, Gollmitzer, I, Loeffelbein, DJ, Holzle, F, Wolff, KD. Botulinum toxin for treatment of gustatory sweating. A prospective randomized study [in German]. Mund Kiefer Gesichtschir 2004;8:369–75CrossRefGoogle ScholarPubMed
16 Laccourreye, O, Akl, E, Guttierez-Fonseca, R, Garcia, D, Brasnu, D, Bonan, B. Recurrent gustatory sweating (Frey syndrome) after intracutaneous injection of botulinum toxin. Arch Otolaryngol Head Neck Surg 1999;125:283–6CrossRefGoogle ScholarPubMed
17 Beerens, AJ, Snow, GB. Botulinum toxin A in the treatment of patients with Frey syndrome. Br J Surg 2002;89:116–19CrossRefGoogle ScholarPubMed
18 Guntinas-Lichius, O. Increased botulinum toxin type A dosage is more effective in patients with Frey's syndrome. Laryngoscope 2002;112:746–9CrossRefGoogle ScholarPubMed
19 Filho, WQ, Dedivitis, RA, Rapoport, A, Guimaraes, AV. Sternocleidomastoid muscle flap preventing Frey syndrome following parotidectomy. World J Surg 2004;28:361–4CrossRefGoogle ScholarPubMed
20 Kerawala, CJ, McAloney, N, Stassen, LF. Prospective randomised trial of the benefits of a sternocleidomastoid flap after superficial parotidectomy. Br J Oral Maxillofac Surg 2002;40:468–72CrossRefGoogle ScholarPubMed
21 Taylor, SM, Yoo, J. Prospective cohort study comparing subcutaneous and sub-superficial musculoaponeurotic system flaps in superficial parotidectomy. J Otolaryngol 2003;32:71–6CrossRefGoogle ScholarPubMed
22 Sinha, UK, Saadat, D, Doherty, CM, Rice, DH. Use of AlloDerm implant to prevent Frey syndrome after parotidectomy. Arch Facial Plast Surg 2003;5:109–12CrossRefGoogle ScholarPubMed