[First use of botulinum toxin type B in ENT patients with secondary therapy failure of botulinum toxin type A].

The first botulinum toxin type B (BT-B) formulation, NeuroBloc, has been licensed in Germany for the treatment of cervical dystonia since March 2001. This allows the treatment of patients with secondary failure of botulinum type A (BT-A) injections for the first time. Three patients with such a secondary failure were successfully treated with BT-B. A total of 1,000 mouse units (MU) NeuroBloc per eye were injected in a patient with blepharospasm. The treatment was effective for 4 months. In a patient with spasmodic dysphonia, 250 MU were injected into each vocal cord. This was effective for 3.5 months. The third patient suffered from bilateral Frey's syndrome. A total of 7,500 MU were used on the right side and 6,000 MU on the left side to stop the gustatory sweating for 9 months. Overall, BT-B showed similar intervals of effectiveness as BT-A. Side effects were not seen using the above dosage regimes.