Frey综合征的现代治疗选择——附5例分析

M. Hudečková, E. Minks, P. Urbánková, B. Gál
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摘要

简介:Frey’s syndrome (SF),即耳颞综合征,是一种常被忽视的并发症,根据最近的研究,6-96%的腮腺手术后患者发生这种并发症。它是在耳颞神经损伤后副交感神经纤维异常长入失神经汗腺鞘的基础上产生的。该综合征的特点是三种症状:出汗、发红、灼热甚至与食物摄入有关的疼痛。诊断这些问题不是一个耗时的过程,而且有许多治疗选择。然而,绝大多数的方法,无论是手术还是非手术,只有短期的效果,并伴有一些并发症。肉毒毒素A (BTXA)的应用代表了一种相对简单、有效和安全的治疗选择,包括根据预先确定的Frey综合征激活图皮内应用该溶液。目的:介绍并评价肉毒毒素在弗雷氏综合征患者中的应用。材料与方法:回顾性分析2006年至2019年在布尔诺圣安妮大学医院耳鼻喉头颈外科接受不同程度腮腺手术的5例患者,其中有明显的SF症状表现,并在此基础上应用肉毒酶a进行治疗。结果:对本组所有患者SF的主观表现进行评估,在应用肉毒毒素后,SF的问题从“恼人并降低其生活质量”明显减少到“从未”或“几乎从未”发生。通过SketchAndCalc解析Minor测试的客观结果显示,SF激活平均下降91.6%。只有两名患者需要每隔6个月和19个月重新给药。没有报告或观察到任何患者对肉毒毒素的不良反应。结论:肉毒毒素是一种有效、安全的治疗弗雷氏综合征的方法。关键词:腮腺切除术-弗雷综合征-耳颞综合征-味觉出汗-肉毒杆菌A毒素
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Modern therapeutic options for Frey syndrome – analysis of five cases
Introduction: Frey‘s syndrome (SF), auriculotemporal syndrome, is an often neglected complication occurring in 6–96% of patients after parotid gland surgery according to recent studies. It arises on the basis of aberrant ingrowth of parasympathetic fi bers into the sheaths of denervated sweat glands after auriculotemporal nerve damage. The syndrome is characterized by a triad of symptoms: sweating, redness and burning or even pain in connection with food intake. Diagnosing these problems is not a time-consuming process and there are a number of therapeutic options. However, the vast majority of approaches, whether surgical or non-surgical, have only a short-term effect and carry a number of complications. The application of botulinum toxin A (BTXA) represents a relatively simple, effective and safe treatment option consisting of intradermal application of the solution according to a predetermined Frey syndrome activation map. Objectives: Presentation and evaluation of pilot results of therapeutic application of BTXA in patients dia gnosed with Frey‘s syndrome. Material and methods: Retrospective analysis of a group of 5 patients who underwent parotid gland surgery of various extents at the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital at St. Anny in Brno between 2006 and 2019, in whom there was a signifi cant manifestation of SF symptoms on the basis of which BTXA was therapeutically applied. Results: Evaluating the subjective manifestations of SF in all patients in our cohort, after the application of BTXA, showed that the problems signifi cantly decreased from “annoying and reducing their quality of life” to “never” or “almost never” occurring. Objective results of the Minor test interpreted by SketchAndCalc showed a decrease in SF activation of 91.6% on average. Only two patients required re-administration of BTXA at 6 and 19 months intervals. No adverse reactions to BTXA were reported or observed with any of the patients. Conclusion: BTXA is an eff ective and safe way to treat patients with Frey‘s syndrome. Keywords: parotidectomy – Frey syndrome – auriculotemporal syndrome – gustatory sweating – botulinum A toxin
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