Frey's syndrome (gustatory sweating) after parotidectomy is caused by aberrant regeneration of which type of nerve fibres?

• A Sympathetic fibres of the great auricular nerve growing into sweat gland-innervating pathways
• B Parasympathetic secretomotor fibres of the auriculotemporal nerve (branch of CN V3) growing into sympathetic pathways to sweat glands ✓
• C Somatic sensory fibres of the lesser occipital nerve
• D Sympathetic fibres from the superior cervical ganglion to the parotid gland

Explanation

Frey's syndrome occurs when parasympathetic secretomotor fibres originally destined for the parotid gland (via the auriculotemporal nerve, branch of V3, carrying fibres from the otic ganglion) regenerate and aberrantly innervate sweat glands and cutaneous blood vessels of the preauricular skin. Sweating and flushing are then triggered by salivary stimuli (meals) rather than temperature. Treatment includes intradermal botulinum toxin type A.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.