Frey's syndrome (gustatory sweating) following parotidectomy occurs due to aberrant regeneration of which nerve fibers to sweat glands of the skin overlying the parotid?

• A Sympathetic fibers from superior cervical ganglion to sweat glands
• B Sympathetic fibers of auriculotemporal nerve to parotid acini
• C Parasympathetic fibers of auriculotemporal nerve misdirected to sweat glands ✓
• D Parasympathetic fibers of chorda tympani to sweat glands

Explanation

Frey's syndrome results when parasympathetic secretomotor fibers (originally supplying parotid gland via the auriculotemporal nerve from the otic ganglion) regenerate aberrantly and innervate sweat glands and skin blood vessels in the same territory. As a result, gustatory stimuli trigger sweating and flushing of the cheek skin rather than salivation. The auriculotemporal nerve normally carries postganglionic parasympathetic fibers from the otic ganglion to the parotid; after surgical disruption, these fibers can misdirect to sweat glands.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.