Repeated botulinum toxin type A injections to treat patients with frey syndrome

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 botu- linum 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 ofsymptoms, as assessed bythe 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. Uni- variate 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 botu- linum toxin type A lowered subjective symptom scores, decreased the size of the affected area, and increased the duration of the effect.