What is Frey Syndrome : Causes, Symptoms, Treatment, Prevention

Frey Syndrome is a pathological condition which is quite common in people who undergo a surgical procedure involving the parotid gland. Frey Syndrome is associated with increased sweating with eating and facial flushing.

The main cause of Frey Syndrome is an injury to the auriculotemporal nerve which usually occurs when an individual undergoes a parotid gland surgery. Post healing of the nerve, it attaches to the sweat glands instead of the salivary glands resulting in unusual sweating when eating food causing Frey Syndrome.

The unusual sweating may also occur when the individual is sleeping or even thinking about some food which tends to produce excess salivation. The areas where the affected individual tends to sweat the most are the temples, cheek, and the neck region as a result of Frey Syndrome.

Frey Syndrome is seen in almost all the patients who undergo parotid gland procedure and do not have a reconstructive procedure which keeps the healing nerve from attaching to the sweat glands.

Unusual sweating and facial flushing when eating are the main presenting features of Frey Syndrome. This basically occurs on the cheek, temples, and the neck areas specifically behind the ears. In majority of the cases, the symptoms are mild and not a cause for concern but in some cases the symptoms may be severe which may require measures to treat the symptoms of Frey Syndrome.

Symptoms of Frey Syndrome are quite variable and treatment is mostly sought for people who have severe and intolerable symptoms as a result of Frey Syndrome.

After listening to the symptoms of the patient and arriving at a suspicion of Frey Syndrome, the physician may do a simple iodine and starch test. In this test, iodine is applied on the affected area of the face. Once the iodine dries, starch is applied to the area. The patient is then given something to eat. If the patient sweats when eating as will be the case with Frey Syndrome the patch of area where the iodine and starch was applied will turn dark thus confirming a diagnosis of Frey Syndrome.

In mild cases of Frey Syndrome, there is no particular treatment that is required. In cases where the symptoms are more bothersome and severe there are various treatment options that are available. Topical anticholinergic ointments like scopolamine are quite beneficial for treating symptoms of Frey Syndrome.

Additionally, deodorants or botox injections have also shown significant efficacy in treatment of Frey Syndrome. Botox treatment by far is the most preferred form of treatment as it provides the longest symptom relief and is extremely easy to do when it comes to treatment of Frey Syndrome.

The above mentioned treatments may be quite beneficial in taking away the symptoms of Frey Syndrome but these treatments are only temporary and for a permanent solution the only route is through surgical reconstruction. It not only treats Frey Syndrome but also reduces any facial scars that may have been present from the initial parotid gland surgery which caused the patient in the first place to have Frey Syndrome, although there are only a handful of surgeons that can do both of these surgeries effectively.

Coming to how the surgery is done, it begins with careful elevation of the skin paying close attention to any facial nerve branches that may be there and avoid any injury to them. Once this is done, a healthy tissue is harvested and appropriated to the size of the defect.

This graft is carefully sutured to the facial muscles thus reconstructing the natural muscular support. The function of the graft is to close off the sweat glands and cure Frey Syndrome.

The best way to prevent Frey Syndrome is to avoid any trauma during a surgery to the parotid gland. The only way for this to be possible is by utilizing minimally invasive technique which is quite preferred these days for various surgical conditions.

This not only protects the nerves and its branches but also successfully accomplishes the goals of the surgery without doing any damage to any of the nerves which may result in conditions like Frey Syndrome.

References: