Xie Shang, Wang Kan, Xu Tao, Guo Xue-Sheng, Shan Xiao-Feng, Cai Zhi-Gang
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, China.
Department of Stomatology, Capital Medical University Pinggu Teaching Hospital, Beijing, 101200, China.
Cancer Med. 2015 Nov;4(11):1639-50. doi: 10.1002/cam4.504. Epub 2015 Aug 26.
Frey's syndrome (FS) is an unavoidable sequela following the surgery of the parotid gland. Although several treatment methods are available, their efficacy is short term or accompanied by unacceptable complications. In the past two decades, botulinum toxin type A (BTXA) has been widely used to treat FS. Although several systematic reviews have been reported recently, they were conflicting and with obvious deficiencies. Thus, we performed an objectively systematic review to determine whether BTXA is an effective and safe treatment for FS. A literature retrieval covering PubMed, Web of Science, Ovid, Embase and Cochrane library was performed on 16 January, 2015. Proportion meta-analysis and corresponding 95% confidence interval (CI) were performed to evaluate the efficacy and safety of BXTA in treatment of FS. A total of 499 records were retrieved and 22 articles with 23 studies were included after scrutiny by two independent authors. Statistical analyses regarding the effective rate, incidence of complications were used to estimate the efficacy and safety of BTXA. Our results suggested that the effective rate of BTXA for treatment of FS is 98.5% (95% CI = 0.971-0.994) and the incidence of complication is 3.6% (95% CI = 0.017-0.061). In conclusion, our study supports that BTXA produces meaningful benefits on the treatment of patients with FS. However, owing to lack of strong evidence, future studies with well-designed inclusion criteria and multicenter randomized controlled trials are needed to give more credible evidence, if possible.
弗雷综合征（FS）是腮腺手术后不可避免的后遗症。尽管有多种治疗方法，但它们的疗效是短期的，或者伴有难以接受的并发症。在过去二十年中，A型肉毒杆菌毒素（BTXA）已被广泛用于治疗FS。尽管最近有几项系统评价报告，但结果相互矛盾且存在明显不足。因此，我们进行了一项客观的系统评价，以确定BTXA治疗FS是否有效且安全。2015年1月16日，我们在PubMed、科学网、Ovid、Embase和Cochrane图书馆进行了文献检索。采用比例Meta分析及相应的95%置信区间（CI）来评估BTXA治疗FS的疗效和安全性。共检索到499条记录，经两位独立作者仔细审查后，纳入了22篇文章共23项研究。采用有效率、并发症发生率等统计分析方法来评估BTXA的疗效和安全性。我们的结果表明，BTXA治疗FS的有效率为98.5%（95%CI=0.971-0.994），并发症发生率为3.6%（95%CI=0.017-0.061）。总之，我们的研究支持BTXA对FS患者的治疗有显著益处。然而，由于缺乏有力证据，如果可能的话，未来需要设计良好纳入标准的研究和多中心随机对照试验来提供更可靠的证据。
