Frey's syndrome--unusually long delayed clinical onset post-parotidectomy: a case report

Abstract

Frey's syndrome is a complication of parotidectomy that is thought to occur as a result of aberrant regeneration of the postganglionic parasympathetic nerve fibres supplying the parotid gland to severed postganglionic sympathetic fibres which innervate the sweat glands of the face. Frey's syndrome is difficult to treat but is a preventable phenomenon and surgeons must be aware of the available preventative methods during the initial surgery. An unusual case is presented involving a patient with delayed onset of Frey's syndrome 40 years after parotidectomy in childhood. The potential for this long-delayed clinical presentation should be discussed with the patient before surgery in the parotid gland. Diagnostic methods, preventive measures and management options are briefly discussed.

Keywords: Frey’s syndrome-parotidectomy-gustatory sweating.

Figure 1:

Shows a right cervico-mastoid-facial incision from a previous parotidectomy at the age of 7 years

Figure 2:

This picture shows the typical gustatory sweating and flushing of Frey’s Syndrome post-parotidectomy