An Alternative Treatment for Frey Syndrome

The Use of Acellular Dermis in the Prevention of Frey's Syndrome

“… 12 More recently, established Frey's Syndrome is treated through the use of nonsurgical methods, such as topical glycopyrrolate 13–15 and cutaneous injections of botulinum toxin type A, 3,4 and surgical methods have been reserved for Frey's Syndrome refractory to medical treatment, 12 and more importantly for the prevention of Frey's Syndrome using the concept of a barrier method. 8,16–20 Studies examining the efficacy of Botox (Allergan, Inc., Mougins, France) have demonstrated mean durations of effect from 12.1 months to 17.3 months 3,4,21 ; however, Laskawi and Drobik have the largest group of patients treated with Botox and demonstrate a mean duration of effect of 17.3 months. 21 Other studies more or less concur with these numbers; however, of particular note is that although 100% of patients respond to botulinum toxin type A, there is nearly always the need for subsequent injections.…”

“…Dermal grafts have been used for the treatment of Frey's Syndrome 16,17 ; however, they have not received a great deal of attention because there is a need for a donor site and increased operative time. Synthetic barriers were evaluated by Dulguerov et al in a prospective study that evaluated lyophilized dura, polyglactin 910‐polydioxanone (Ethisorb; Ethicon, Spreitenbach, Switzerland), expanded polytetrafluoroethylene (ePTFE).…”

Management of frey syndrome

“…The most commonly used method consists of reelevation of the cheek skin flap and interposition of various tissue barriers like dermal graft and temporoparietal fascia between the cheek skin and the parotid gland. 35,36 Reelevation of the skin flap and excision of the involved skin followed by skin grafting have also been used. These procedures result in a donor site scar and harbor the risk of facial nerve injury.…”

Fat injections for the management of post-parotidectomy Frey syndrome: A technical note

“…Although many treatments have been proposed (Hays et al, 1982;MacKinnon and Lovie, 1999;Beerens and Snow, 2002;de Bree et al, 2007), there is no treatment of choice for post-parotidectomy Frey syndrome (de Bree et al, 20079): local medical therapies gave only transient results (de Bree et al, 2007), and more invasive surgical procedures are burdened by the risk of facial nerve injury (de Bree et al, 2007).…”

“…Local therapies include anticholinergic ointments (scopolamine, glycopyrrolate) (de Bree et al, 2007), or multiple intracutaneous botulinum toxin A injections (Beerens and Snow, 2002;Capaccio et al, 2008); more invasive surgical procedures include tympanic neurectomy (Hays et al, 1982) or the interposition of a dermal graft and temporoparietal fascia (MacKinnon and Lovie, 1999) between the skin and residual parotid tissue with the risk of possible facial nerve injury (de Bree et al, 2007).…”