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Frey's syndrome after parotid surgery

A B Gordon, R V Fiddian

    American Journal of Surgery
    |July 1, 1976
    PubMed
    Summary

    Frey's syndrome, a common complication of parotid surgery, involves gustatory sweating. Identifying the specific nerve involvement, like the auriculotemporal nerve, is crucial for surgical outcomes.

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    Area of Science:

    • Otolaryngology
    • Neurosurgery
    • Facial Nerve Surgery

    Background:

    • Parotid surgery, particularly suprafacial parotidectomy, can lead to Frey's syndrome.
    • Frey's syndrome is characterized by gustatory sweating and facial flushing.
    • Understanding nerve involvement is key to managing this complication.

    Purpose of the Study:

    • To review the incidence and nerve involvement in Frey's syndrome post-parotid surgery.
    • To describe an adjunct method for investigating Frey's syndrome.
    • To provide guidance on surgical nerve management to prevent Frey's syndrome.

    Main Methods:

    • Retrospective review of 71 parotid surgery cases (1964-1973).
    • Clinical reassessment of 50 patients for Frey's syndrome.
    • Diagnostic investigation using Minor's starch test and a novel contralateral greater auricular nerve block technique.

    Main Results:

    • 17 out of 50 reassessed patients (34%) exhibited noticeable Frey's syndrome.
    • Minor's test implicated the greater auricular nerve in 6 patients, auriculotemporal nerve in 4, and both in 2.
    • The described nerve block adjunct effectively mapped sensory distribution.

    Conclusions:

    • Avulsing the auriculotemporal nerve is inadvisable when sweating distribution aligns with the greater auricular nerve.
    • Accurate diagnosis of nerve involvement is essential for preventing or managing Frey's syndrome.
    • The described diagnostic adjunct aids in precise localization of nerve dysfunction.

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