The use of botulinum toxin type A in the treatment of Frey and crocodile tears syndromes

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
Dionysios E KyrmizakisEmmanuel S Helidonis

Abstract

We sought to investigate the efficacy of botulinum toxin type A in the treatment of Frey and crocodile tears syndromes. Frey syndrome is a common complication after surgical intervention or injury in the region of the parotid gland. Crocodile tears syndrome is unusual and manifests after facial nerve paralysis and other causes such as head trauma. This was a prospective nonrandomized, nonblinded study. We used botulinum toxin type A for the treatment of 11 patients with gustatory sweating and 2 patients with crocodile tears syndrome. The follow-up (6 to 23 months) of patients with gustatory sweating syndrome showed complete absence of sweating in the affected regions. One patient had recurrence after 16 months and was retreated successfully. At 1 and 24 weeks after treatment of the patients with the crocodile tears syndrome, the Schirmer test showed a reduction of stimulated lacrimation on the impaired side approaching the normal values of the unaffected side. Our study supports the widely accepted aspect that botulinum toxin type A could be the treatment of choice for gustatory sweating syndrome. We also propose the toxin as a valuable treatment for crocodile tears syndrome.

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Citations

Sep 8, 2007·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·B Wabbels, M Förl
Nov 7, 2012·Ophthalmic Plastic and Reconstructive Surgery·Anna M DemetriadesShannath L Merbs
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Dec 3, 2014·Otolaryngologic Clinics of North America·Paul LennonReza Rahbar
Jan 25, 2007·Expert Opinion on Investigational Drugs·Réginald Ansiaux, Bernard Gallez
Jan 11, 2007·Survey of Ophthalmology·Jonathan J Dutton, Amy M Fowler
Jul 28, 2006·Parkinsonism & Related Disorders·Daniel D Truong, Wolfgang H Jost
Dec 22, 2017·Annals of Maxillofacial Surgery·Jigna S Shah, Vijay K Asrani
Nov 23, 2006·Ophthalmic Plastic and Reconstructive Surgery·Angel Nava-CastañedaYonathan Garfias
Jan 19, 2007·Head & Neck·Remco de BreeC René Leemans
Feb 28, 2008·The Laryngoscope·Victor HelmstaedterOrlando Guntinas-Lichius
Mar 19, 2008·Archives of Facial Plastic Surgery·Ritvik P Mehta, Tessa A Hadlock

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