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Repeated Botulinum Toxin Type A Injections to Treat Patients With Frey Syndrome
Remco de Bree, MD, PhD;
Jeff E. Duyndam, MD;
Dirk J. Kuik, MSc;
C. René Leemans, MD, PhD
Arch Otolaryngol Head Neck Surg. 2009;135(3):287-290.
Objective To determine the effectiveness of repeated intracutaneous injections of botulinum toxin A to treat Frey syndrome.
Patients Between January 6, 1999, and July 1, 2005, 22 patients with Frey syndrome (12 men and 10 women) received repeated intracutaneous injections of botulinum toxin type A.
Main Outcome Measures Before each treatment, the time since the previous treatment; the size of the affected area, as determined by a starch-iodine test; and subjective quantification of symptoms, as assessed by the previously used Frey Questionnaire Card, were recorded.
Results All patients underwent at least 3 treatments. Univariate analysis of variance showed a significant difference (P <.001) in the between-treatment interval. Univariate analysis of variance showed a significant difference in the size of the affected area in accordance with the number of treatments received (P <.001). The mean Frey Questionnaire Card score also decreased with repeated treatments.
Conclusions In patients with Frey syndrome, repeated treatment with intracutaneous injection of botulinum toxin type A lowered subjective symptom scores, decreased the size of the affected area, and increased the duration of the effect.
Author Affiliations: Departments of Otolaryngology/Head and Neck Surgery (Drs de Bree, Duyndam, and Leemans) and Clinical Epidemiology and Biostatistics (Mr Kuik), VU University Medical Center, Amsterdam, the Netherlands.
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