Frey syndrome is characterized by unilateral flushing and sweating of the facial skin innervated by the auriculotemporal nerve (neck, parotid region, and. A neurologist from Poland, Dr. Lucja Frey, provided a detailed assessment of the disorder and coined the term “auriculotemporal syndrome” in Auriculotemporal nerve syndrome, also known as Frey syndrome, is an uncommon clinical entity in children. It is widely thought to be the result.

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Auriculotemporal nerve syndrome / Frey syndrome/Gustatory sweating

The incidence of Frey syndrome following parotidectomy: Bonanno and colleagues 19 found this technique overwhelmingly effective in preventing the development of Frey syndrome, while other groups failed to demonstrate its ability to do so. Treatment of postparotidectomy Frey syndrome with the interposition of temporalis fascia and sternocleidomastoid flaps.

Treatment is symptomatic and directed toward relief of symptoms. The exact underlying mechanisms that cause Frey syndrome are not fully understood.

Auriculotemporal Syndrome (Frey Syndrome).

Abstract Frey syndrome is a common sequela of parotidectomy, and although it is not frequently manifested clinically, it can cause significant morbidity for those affected. This is because the Frey syndrome starts manifesting at the time akriculotemporal introduction of the solid foods around 6 months of age.

In some cases, Frey syndrome may not develop until several years after surgery. Powered By Decision Support in Medicine. Affected Populations The exact incidence of Frey syndrome is unknown. Journal of Oral and Maxillofacial Surgery. Get free access to newly published articles. Adenosquamous carcinoma Basaloid squamous carcinoma Mucosal melanoma Spindle cell carcinoma Squamous cell carcinoma Verrucous carcinoma Oral florid papillomatosis Oral melanosis Smoker’s melanosis Pemphigoid Benign mucous membrane Pemphigus Plasmoacanthoma Stomatitis Aphthous Denture-related Herpetic Smokeless tobacco keratosis Submucous fibrosis Ulceration Riga—Fede disease Verruca vulgaris Verruciform xanthoma White sponge nevus.

Although Frey syndrome can be mild and well-tolerated, in auriiculotemporal individuals, it can cause excessive discomfort. The other possible etiologic factors include parotitis, mandibular condylar fracture, blunt trauma, herpes zoster, associated central nervous syndromr disorders such as syringomyelia, epilepsy, and meningioma auriculotrmporal the cerebellopontine angle tumor. New England Journal of Medicine.


In older reports, infections of the parotid glands were suspected, but a detailed examination always points to a surgical drainage of a parotid abscess. Abdominal fat grafting Abdominal fat implantation to the parotidectomy defect is a commonly used technique for decreasing the postsurgical defect and improving cosmesis. A survey conducted by Baek and colleagues 7 revealed that Frey syndrome was the most commonly self-perceived consequence of parotidectomy in a group undergoing auriculotemporl for benign disease.

Sign in to access your subscriptions Sign in to your personal sjndrome. The exact incidence syndrme Frey syndrome is unknown. Food allergy is bilateral and presents with itching, urticaria, angioedema, or systemic symptoms or anaphylaxis. Although this represents an effective technique for the prevention of Frey syndrome, it does require an extended incision, which can generally be hidden in the hairline.

Although intraoperative techniques try to reduce severity and incidence of Frey syndrome, postoperative interventions have been focused on ameliorating symptoms once they develop.

Symptoms are often mild and well-tolerated. A Normal innervation of the parotid gland by the postganglionic parasympathetic nerve fibers from the auriculotemporal nerve. The erythema and flushing begin within minutes of eating the first bite of a favorite food and last for about 20 to 60 minutes.

The affected area of the face is painted with iodine which is allowed to dry, then dry corn starch is applied to the face.

What to be alert for in the history In children, it is typically noted around 6 months of age at the time of introduction of solid foods fruit snacks to the diet. This SMAS flap can be harvested using a standard modified Blair incision or the facelift incision, and the SMAS can be easily separated from the overlying skin and the parotid tissue to be tightly plicated to the ear perichondrium and the SCM muscle, creating a tight surface that prevents the retromandibular collapse for improved contouring.


Retrieved 18 December Meta-analysis of surgical techniques for preventing parotidectomy sequelae. The Auriculotemporal branch of the Trigeminal nerve carries parasympathetic fibers to the sweat glands of the scalp and the parotid salivary gland. In addition, abdominal fat harvest requires an additional incision on the abdomen and can frequently be complicated by donor site hematoma and surgical site seroma.

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Temporoparietal fascia flap The temporoparietal fascia flap TPFF is a broad, vascularized fascia flap that is based off the superficial temporal artery Fig. The treatment is only supportive.

Another rarely described cause etiology of Frey syndrome is damage to the main sympathetic nerve chain in the neck. Additional symptoms that may be associated with Frey syndrome include flushing and warmth in the affected areas. The percentage of individuals who develop Frey syndrome after a parotidectomy is controversial and reported estimates range from percent.

In follow-up examinations, approximately 15 percent of affected individuals rated their symptoms as severe. The parents need simple reassurance and counselling. Br J Plast Surg. Both patients were relieved permanently of this annoying syndrome by intracranial division of the glossopharyngeal nerve. Sternocleidomastoid muscle flap, and 4.

Unusual Clinical Scenarios to Consider in Patient Management Frey syndrome is a masquerader of food allergy, especially in children. In both patients there was a history of parotitis following abdominal surgery.

The sternocleidomastoid SCM muscles flap is a muscular flap with a tripartite blood supply. It described sweating and flushing in the preauricular area in response to mastication or a salivary stimulus.