Laccourreye O, Akl E, Gutierrez-Fonseca R, Garcia D, Brasnu D, Bonan B
Department of Otorhinolaryngology-Head and Neck Surgery, Hôpital Laënnec, Assistance Publique Hôpitaux de Paris, University Paris V, France.
Arch Otolaryngol Head Neck Surg. 1999 Mar;125(3):283-6. doi: 10.1001/archotol.125.3.283.
To evaluate the duration of effectiveness of intracutaneous injection of botulinum toxin type A for gustatory sweating as well as the incidence, severity, management, and outcome of recurrent gustatory sweating.
An inception cohort with a minimum of 18 months of follow-up.
A tertiary care center and university teaching hospital.
Thirty-three patients with severe gustatory sweating.
Intracutaneous injection of 25 to 175 IU (mean, 86 IU) of botulinum toxin type A.
Analysis of the effectiveness of the intracutaneous injection of botulinum toxin type A using the Kaplan-Meier actuarial life-table method; completion of the Minor starch-iodine test in patients without symptomatic recurrent gustatory sweating; and the patients' self-assessment of the severity of the recurrent gustatory sweating.
The 1-, 2-, and 3-year actuarial estimate for symptomatic recurrent gustatory sweating was 27%, 63%, and 92%, respectively. In the 7 patients without symptomatic recurrent gustatory sweating, the Minor starch-iodine test revealed persistent gustatory sweating in 6, resulting in an overall 97% rate (32 of 33 patients) for recurrent gustatory sweating. No statistical relationship could be demonstrated between the duration of effectiveness, the incidence of recurrent gustatory sweating, the severity of recurrent gustatory sweating, and the following variables: age, sex, cause of gustatory sweating, skin surface involved, and dose of botulinum toxin type A injection. Within the group of 26 patients with symptomatic recurrent gustatory sweating, (1) the severity of the recurrent gustatory sweating was always reduced when compared with the severity of the initial gustatory sweating, and (2) the recurrent gustatory sweating always remained amenable to reinjection of botulinum toxin type A.
The present series demonstrated a linear regression in the effectiveness of the intracutaneous injection of botulinum toxin type A in patients with gustatory sweating, while no factors appeared to be statistically related to the duration of effectiveness and/or the incidence of recurrent gustatory sweating. However, because the severity of recurrent gustatory sweating is reduced when compared with the severity of the initial gustatory sweating and because recurrent gustatory sweating remains amenable to reinjection of botulinum toxin type A, we believe that the intracutaneous injection of botulinum toxin type A should become the first-line treatment option in patients with gustatory sweating.
评估皮内注射A型肉毒杆菌毒素治疗味觉性出汗的有效持续时间以及复发性味觉性出汗的发生率、严重程度、处理方法和结果。
起始队列，至少随访18个月。
三级医疗中心和大学教学医院。
33例严重味觉性出汗患者。
皮内注射25至175国际单位（平均86国际单位）的A型肉毒杆菌毒素。
采用Kaplan-Meier精算生命表法分析皮内注射A型肉毒杆菌毒素的有效性；对无症状复发性味觉性出汗患者进行Minor淀粉碘试验；患者对复发性味觉性出汗严重程度的自我评估。
有症状的复发性味觉性出汗的1年、2年和3年精算估计分别为27%、63%和92%。在7例无症状复发性味觉性出汗的患者中，Minor淀粉碘试验显示6例存在持续性味觉性出汗，导致复发性味觉性出汗的总体发生率为97%（33例患者中的32例）。有效性持续时间、复发性味觉性出汗的发生率、复发性味觉性出汗的严重程度与以下变量之间无统计学关系：年龄、性别、味觉性出汗的原因、受累皮肤表面以及A型肉毒杆菌毒素注射剂量。在26例有症状的复发性味觉性出汗患者组中，（1）与初始味觉性出汗的严重程度相比，复发性味觉性出汗的严重程度总是降低的，（2）复发性味觉性出汗总是可以再次注射A型肉毒杆菌毒素。
本系列研究表明，皮内注射A型肉毒杆菌毒素治疗味觉性出汗患者的有效性呈线性回归，而似乎没有因素与有效性持续时间和/或复发性味觉性出汗的发生率有统计学关系。然而，由于与初始味觉性出汗的严重程度相比，复发性味觉性出汗的严重程度降低，且复发性味觉性出汗仍可再次注射A型肉毒杆菌毒素，我们认为皮内注射A型肉毒杆菌毒素应成为味觉性出汗患者的一线治疗选择。
