Six months after a superficial parotidectomy for a benign tumour, a 45-year-old man reports flushing and beads of sweat appearing on the skin over the surgical site within minutes of starting a meal. The episode resolves shortly after he finishes eating. Which nerve mediates this phenomenon through aberrant regeneration of its secretomotor fibres?

• A Greater auricular nerve
• B Auriculotemporal nerve ✓
• C Marginal mandibular branch of facial nerve
• D Buccal branch of facial nerve

Explanation

Gustatory sweating and flushing in the preauricular area after parotid surgery is Frey syndrome. Parasympathetic secretomotor fibres destined for the parotid travel with the auriculotemporal nerve; after injury they regenerate abnormally to innervate sweat glands and cutaneous vessels supplied by the same nerve, producing sweating on chewing. The greater auricular nerve is sensory only, so it cannot mediate the response, which eliminates it as the answer.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.