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PubMed2006

A review of the current uses of Botox for dentally-related procedures.

UNLABELLED: Botox is the most widely used abbreviation for botulinum toxin type A (BtA). This drug has received wide coverage in the press and media for its cosmetic advantages, especially in the facial region. The clinician may be aware of the many courses becoming available and aimed at dentists to start using it in the cosmetic context. This paper intends to provide a basic understanding of the many functional uses of the drug in the orofacial region that may be relevant to everyday practice. CLINICAL RELEVANCE: Awareness of the current medical, as opposed to purely cosmetic, uses of botulinum toxin in the orofacial region is desirable and this paper should inform clinicians and their patients with respect to this increasingly popular drug.

Botulinum Toxins, Type A↗
PubMed2003

The use of botulinum toxin in head and neck disorders.

Not only can botulinum toxin be used for cervical and laryngeal dystonia but in this article its use and complications in the management of oromandibular dystonia, Frey's syndrome, crocodile tears and drooling is described.

Anti-Dyskinesia Agents↗
PubMed2000

Malignant pheochromocytoma lacking clinical features of catecholamine excess until the late stage.

A malignant pheochromocytoma is described in a 71-year-old man. Osseous metastases became manifest 12 years after successful removal of the primary tumor which originated in paraganglionic tissue near the right adrenal gland. Although the patient had no symptoms of catecholamine excess initially, hypertension, tachycardia and excessive sweating appeared several months before his death, concomitantly with a sharp increase in noradrenaline secretion due to an accelerated growth of metastatic tumors. Since there is no histologic criterion of malignancy in this neoplasm, it would be prudent to consider every case of pheochromocytoma as potentially malignant and to follow-up carefully for a long time after removal of the primary tumor.

Adrenal Gland Neoplasms↗
PubMed2003

Prospective cohort study comparing subcutaneous and sub-superficial musculoaponeurotic system flaps in superficial parotidectomy.

OBJECTIVE: To compare subcutaneous and sub-superficial musculoaponeurotic system (SMAS) flaps with regard to aesthetic result and Frey's syndrome following superficial parotidectomy. SETTING: A tertiary care centre. METHODS: A prospective cohort study of 45 patients who underwent superficial parotidectomies for benign disease between 1991 and 1996. All 45 patients completed self-administered questionnaires. Questions regarding perception of a facial contour deformity, Frey's syndrome, and scar rating were included. A total of 28 patients agreed to further direct patient evaluation where starch-iodine testing, photographs of the facial scar and contour, and facial nerve assessment were performed. RESULTS: Overall aesthetic results were acceptable in both groups. Scar rating was consistently higher in the sub-SMAS cohort compared with the subcutaneous group. Similarly, facial contour was found to be superior in the sub-SMAS group. Facial nerve function was normal in both groups. The overall incidence of subjective Frey's syndrome on questionnaire was 45%; however, the incidence of objective Frey's syndrome by starch-iodine testing was higher at 65%. We did not find a significant difference in the incidence of Frey's syndrome between the subcutaneous and the sub-SMAS groups. CONCLUSIONS: Sub-SMAS flaps result in superior facial contours and incisional scars following superficial parotidectomy compared with the subcutaneous flap elevation technique. We found no difference between these flaps with regard to the incidence of Frey's syndrome.

Cicatrix↗
PubMed1993

The usefulness of partial parotidectomy for benign parotid gland tumors. A retrospective study of 306 cases.

This retrospective study concerns benign parotid gland tumors in 306 Japanese patients who were treated by partial parotidectomy with preservation of the facial nerve. There were no recurrences in 112 with a pleomorphic adenoma in over a 5-year follow-up. Facial weakness and temporal paresis occurred in 18% of 232 patients and Frey's syndrome in 18% of 93 with longer than a 3-year follow-up. In comparison with reported results of lateral or superficial parotidectomy, partial parotidectomy with preservation of the facial nerve seems preferable for treatment of patients with a benign parotid gland tumor.

Facial Nerve Injuries↗
PubMed2006

Dermatologic food allergy.

Cutaneous reactions to foods represent one of the most common presentations of food allergy in children. IgE-mediated (urticaria, angioedema, flushing, pruritus), cell-mediated (contact dermatitis, dermatitis herpetiformis), mixed IgE- and cell-mediated (atopic dermatitis), and nonimmune-mediated (irritant contact dermatitis, Frey's syndrome) reactions to foods have all been reported. It is important for the pediatrician to recognize the variety of skin reactions potentially related to food allergy and to consider timely referral to an allergy specialist for further evaluation and definitive diagnosis.

Antibody Specificity↗
PubMed1999

[Clinical study of parotid tumors: a 20 year statistical analysis of 633 cases].

During the 20 years from 1977 to 1996, 633 cases underwent excisions of parotid tumors (539 benign and 94 malignant) in the department of Otolaryngology of Kansai Medical University. The incidence of Warthin's tumors in the years from (1987 to 1996) was higher than that in the years from 1977 to 1986. On the other hand, the incidence of mucoepidermoid carcinomas was less than in previous reports. Tumors accompanied with spontaneous pain or facial nerve palsy and with invasion to both lobes frequently indicated malignancy. Facial nerve palsy caused by either benign or malignant tumors before operation showed no improvement after surgery. The incidences of facial nerve palsy (1.0% in benign, and 18.3% in malignant) and Frey's syndrome (17.8% in benign, and 18.3% in malignant) after surgery were lower than those in other reports of both benign and malignant tumors. Five-year mortality was 76.1%. All deaths that occurred five years after operation involved highly grade malignant tumors.

Adenolymphoma↗
PubMed2004

[Head and neck reconstruction using laparoscopically harvested omentum].

Since the need for laparotomy in harvesting the omentum is the most significant drawback, the omentum has not been the tissue of choice for reconstructive surgery. To compensate for this drawback, we started laparoscopic harvesting of the omentum and clarified the advantages and disadvantages of this procedure. Ten patients underwent laparoscopic harvesting of the omentum by abdominal surgeons, followed by reconstruction of head and neck defects. Surgery was conducted in 5 cases of defect reconstructions for parotid gland tumor surgery and 5 of oropharyngeal defect after cancer surgery. The average harvesting time was 107 minutes (55-140 minutes) and used the omentum and different amounts and length of the vascular pedicle. Although the omentum was successfully transplanted in 9 of 10 cases, 2 cases showed partial peripheral necrosis and 1 total necrosis. With the advantage of laparoscopic harvesting of the omentum, we could obtain appropriate omental size for the defect size. Especially after total parotidecomy, the omentum was useful to fill in the defect, reducing the patients' worries about postoperative deformity. In one case, the omentum was used to treat Frey syndrome, successfully relieving the symptoms. In oropharyngeal reconstruction, the omentum is used to fill dead space and prevented postoperative infection. Although mild abdominal pain was observed a few days after surgery, no major abdominal complications such as intestinal perforation or ileus occurred in the 8 to 39 months following laparoscopic harvest of the omentum. Since the omentum is pliable and easily fills a complicated defect, the omentum is considered satisfactory for reconstructing defects of the lateral face after parotid tumor surgery and small defects after oropharyngeal tumor surgery.

Aged↗