Frey Syndrome: A Novel Classification System Based on Symptom Severity.

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Surgical Complications

Background:

• Frey syndrome (FS) is a common complication following parotidectomy.
• Understanding its incidence and severity is crucial for patient management.
• Existing classification systems may not fully capture the patient-reported symptom burden.

Purpose of the Study:

• To determine the incidence of Frey syndrome in adults and children post-parotidectomy.
• To introduce a practical classification system for subjective Frey syndrome.
• To stratify patients based on symptom severity and management needs.

Main Methods:

• Retrospective chart review and patient survey of 285 individuals undergoing parotidectomy.
• Data collected over 10 years (June 2013-June 2023) at two quaternary care institutions.
• Development of a novel 3-type classification scale for Frey syndrome severity based on patient-reported symptoms.

Main Results:

• Frey syndrome incidence was 22.7% in adults and 55.4% in children.
• The majority of cases were mild (Type 1), affecting 19.2% of adults and 42.9% of pediatric patients.
• Medical or surgical intervention was required in only 3.5% of adults and 12.5% of children.

Conclusions:

• Frey syndrome is a recognized, typically mild complication of parotidectomy with infrequent need for treatment.
• The proposed classification system offers a practical method to describe Frey syndrome severity.
• This tool aids in patient stratification by symptom burden and evaluation of bothersome or painful Frey syndrome.