Frey's syndrome is a phenomenon of hemifacial flushing and sweating after gustatory stimulus, usually secondary to surgical trauma over the parotid gland, although other injury mechanisms may be seen. It is accepted as a result of aberrant regeneration of facial autonomic nerve fibers. Treatment evolved from ineffective medical and surgical approaches to botulinum toxin. We evaluate the effectiveness and safety of botulinum toxin in the treatment of this complication in two patients.
The condition known as Behçet's syndrome was first described by H. Behçet, a dermatologist from Turkey. Its major component is recurrent aphthous-like lesions of the oral mucosa. Some groups of people such as the Japanese are more prone to develop the condition. Behçet's syndrome is relatively rare in the American continent. In addition to oral lesions, these patients may develop recurrent genital ulcerations, uveitis, and pustular vasculitis of the skin, synovitis, and meningoencephalitis. The diagnosis is based on occurrence of internationally proposed major or/and minor criteria and on their combinations. Treatment is challenging and must be tailored to each patient according to the pattern of organ involvement, often requiring use of combined therapies. The clinical picture of the patients in this study confirmed Behçet's Syndrome diagnosis. Vasculitis was evidenced by the absence of bleeding during the handling of some very bloody potential areas. In the present case, not only the triggering but also the complications of rhinosinusitis (periorbitary abscess) were attributed to Behçet's vasculitis, specially the effects on bloody perfusion and draining. Rhinosinusitis is a potential symptom of Behçet's Syndrome. Physicians must pay attention to it in order to achieve satisfactory outcomes.
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