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. 2012 Jul;5(7):48-52.

Frey syndrome in a patient with facial melanoma: auriculotemporal syndrome presenting with gustatory sweating following wide local excision, sentinel node biopsy, and superficial parotidectomy

Richard R Jahan-Tigh, Philip R Cohen

Frey syndrome in a patient with facial melanoma: auriculotemporal syndrome presenting with gustatory sweating following wide local excision, sentinel node biopsy, and superficial parotidectomy

Richard R Jahan-Tigh et al. J Clin Aesthet Dermatol. 2012 Jul.

Abstract

Frey syndrome is characterized by erythema, flushing, and gustatory sweating in the preauricular area. It most commonly occurs after parotid surgery. A 21-year-old man who had a wide local excision, sentinel node biopsy, and superficial parotidectomy for a right temple superficial spreading melanoma and who subsequently developed gustatory sweating in the preauricular area is described. The presentation, diagnosis, pathogenesis, and treatment options of Frey syndrome are reviewed.

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Conflict of interest statement

DISCLOSURE:The authors report no relevant conflicts of interest.

Figures

Figure 1
Figure 1
The lateral view of the right side of a 21-year-old man affected with Frey syndrome. The purple line delineates the area that was affected with gustatory sweating. Scar from his surgical reconstruction can be seen from the patient’s reconstruction anterior to the right ear and extending along the cervical neck.
Figure 2
Figure 2
A closer view of the area affected by gustatory sweating shows that the surgical scar is in the area of the parotid. He also has a mild dermatitis on his face; however, it is interesting to observe that the skin affected by Frey syndrome did not develop eczematous changes.
Figure 3
Figure 3
The parasympathetic and sympathetic nerve fibers travel within the auriculotemporal nerve. In their normal state, they provide parasympathetic input to the parotid and minor salivary glands via the neurotransmitter acetylcholine, and sympathetic innervation to the cutaneous vasculature and sweat glands via both norepinephrine and acetylcholine, respectively (left side). Damage to the para-sympathetic and sympathetic nerve fibers may result in aberrant reinnervation such that parasympathetic signaling may cause gustatory sweating, erythema, warmth, and flushing (right side). ACh=acetylcholine; adnexal structures in skin=cutaneous sweat glands; dotted line=aberrant reinnervation of parasympathetic nerves; NE=norepinephrine; PAROTID=parotid gland; Scalpel=represents damage to the parasympathetic and sympathetic nerves; tubular structure=blood vessel with nerve plexus
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References

    1. Duphenix M. Observations sur les fistules du canal salivaire de Stenon: sur une playe compliquée à la joue ou le canal salivaire fut déchiré. Mémoires Académie Royale de Chirurgie. 1757;3:431–439.
    1. Baillarger M. mémoire sur l’oblitération du canal de Sténon. Gazette Méedicale de Paris. 1853(23):194–197.
    1. Dulguerov P, Marchal F, Gysin C. Frey syndrome before Frey: the correct history. Laryngoscope. 1999;109:1471–1473. - PubMed
    1. Frey L. Le syndrome du nerf auriculo-temporal. Rev Neurol. 1923;2:92–104.
    1. Mehta M, Friedman SG, Frankini LA, Scher LA, Setzen M. Frey’s syndrome after carotid endarterectomy. Ann Vasc Surg. 1999;13:232–234. - PubMed

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