Frey's syndrome (auriculotemporal nerve syndrome) is a recognized complication after parotid surgery. The underlying pathophysiology is:

• A Scarring of the facial nerve branches causing aberrant secretomotor signals
• B Damage to the great auricular nerve causing sensory loss with phantom sweating
• C Aberrant regeneration of parasympathetic secretomotor fibers (from auriculotemporal nerve) into sweat gland sympathetic nerve endings of overlying skin ✓
• D Lymphatic obstruction causing localized hyperhidrosis

Explanation

Frey's syndrome occurs because the parasympathetic secretomotor fibers that originally supplied the parotid gland (traveling via the auriculotemporal nerve) undergo aberrant regeneration after parotidectomy and reinnervate the sweat glands and cutaneous blood vessels of the overlying cheek skin. This causes gustatory sweating and flushing (sweating and redness of cheek skin during eating). Minor's starch-iodine test confirms the area. Treatment options include botulinum toxin injection, antiperspirants, or a fascial interposition flap.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.