Files are available under licenses specified on their description page. If recurrence occurs, the treatment can be repeated. Introduction freys syndrome is caused by a mechanical irritative lesion of the vegetative fibers from the auriculotemporal nerve. Doctors ultimately diagnosed her with frey s syndrome a rare disorder that often occurs as a result of surgery near and around the parotid glands the largest salivary glands in the body. We present the first documented prophylactic approach to freys syndrome that is performed during and as part of parotidectomy.
It may also occur following neck dissection, facelift procedures, or trauma to the area near the parotid gland. This lesion causes an abnormal regeneration of the post. Intracutaneous injection of botulinum toxin a is an effective, long. Imaging confirmed cerebral vacuolisation changes seen in nf1 and a left facial plexiform. The parotid glands are the largest salivary glands in the body located just below the ears on either side of the face.
It was first noted in 1923 by a polish doctor named lucie frey. It most often occurs as a complication of surgery involving the parotid gland a major salivary gland located below the ear. The surgery involves use of the superficial aponeurotic system smas as an interposing flap to interrupt the anastomotic nerve. The main symptoms of frey syndrome are undesirable sweating and flushing occurring on. A 4yearold boy with a history of asthma was referred for evaluation of possible food allergy. A healthy 18monthold girl presented with a history of intermittent hemifacial flushing when eating. Her symptom seemed to be exclusively triggered by chewing. Frey provided a detailed analysis and description as auriculotemporal syndrome in 1923. Freys syndrome also known as baillargers syndrome, dupuys syndrome, auriculotemporal syndrome, or freybaillarger syndrome is a rare neurological disorder resulting from damage to or near the parotid glands responsible for making saliva, and from damage to the auriculotemporal nerve often from surgery the symptoms of freys syndrome are redness and.
Frey syndrome is a common complication after surgery on the parotid gland and temporomandibular joint fracture. Pdf freys syndrome auriculotemporal syndrome or gustatory sweating is a dysfunction of the auriculotemporal nerve, characterized by face flushing. Almost all patients who undergo parotidectomy will to some extent develop frey syndrome auriculotemporal syndrome or. Frey syndrome is characterized by sweating, erythema, and flushing of the facial skin above the parotid bed or of the neck during mastication and is often accompanied by general discomfort in that region. According to the literature, even the most recent therapeutic measures described for the treatment of patients with frey syndrome have little chance of success and a high incidence of side effects.
The symptoms are usually mild, but more severe cases may require medical treatment. Frey syndrome is a rare disorder that most often occurs as a result of surgery in the area near the parotid glands. Freys syndrome is due to damage of the auriculotemporal nerve and leads to sweating and flushing of the face associated with eating or thinking about food. This nerve, when it heals, reattaches to sweat glands instead of the original salivary gland which had been. Freys syndrome is a rare, neurological disorder that causes a person to sweat excessively while eating. Freys syndrome is the most common adverse event after parotidectomy, and usually, it appears after 6 months. The syndrome consists of gustatory sweating, flushing, and warming over the preauricular and temporal areas. It is caused by injury to a nerve, called the auriculotemporal nerve, typically after surgical trauma to the parotid gland. All surgical and topical treatments have drawbacks. He was born at term and the delivery was complicated by failure to progress, requiring the use of forceps.
Frey syndrome, also known as gustatory sweating or auriculotemporal syndrome, is an uncommon condition, but a common sequela of parotidectomy. Freys syndrome was suspected, and the lemon test was performed. The role ofgustatory flushing in freys syndrome and its treatment with botulinum toxin a. Examination revealed cutaneous features of neurofibromatosis type 1 nf1 and mild facial asymmetry. Fs occurs most commonly after surgical procedures involving the parotid gland but may also be encountered after neck dissection or rhytidectomy procedures, or as a. Lucja frey, provided a detailed assessment of the disorder and coined the term auriculotemporal syndrome in auriculotemporal nerve syndrome, also known as frey syndrome, is an uncommon clinical. Repeated botulinum toxin type a injections to treat. Intracutaneous injection of botulinum toxin a is an effective, longlasting, and welltolerated treatment of frey syndrome. He had a history of isolated left facial flushing appearing during meals, extending from the corner of the cheek to the temple and tragus, beginning at 4 months.
Intralesional botulinum toxin gives excellent results in therapy, regardless of the time elapsed between surgery and the first treatment. Thick skin flap and partial superficial parotidectomy are the most important techniques to minimize the risk of developing symptomatic frey syndrome. In our case, symptoms appear 20 years from surgery, an uncommon condition. Evaluation and treatment of frey syndrome medcrave online. The aberrant regeneration theory explains the physiopathology of freys syndrome. Frey syndrome in neurofibromatosis 1 bmj case reports. Frey syndrome auriculotemporal nerve syndrome is characterized by episodes of warmth.
Freys syndrome is characterized by recurrent episodes of facial gustatory flushing and sweating most frequent in adults limited to the cutaneous distribution of the. Frey syndromean underreported complication to closed. Hence, there is need for treatment of freys syndrome. This reaction occurs typically as a response to foods that generally cause extreme salivation and most often it is not associated with pain. Frey s syndrome described initially in 1923, is also known as gustatory sweating syndrome or auriculotemporal nerve syndrome, since the cutaneous injuries associated with this one appear in the area supplied by this branch of the mandibularis nerve. This damage commonly happens during surgical procedures of the parotid gland. The syndrome is characterized by sweating, skin flushing, warmth, and pain associated with eating. It mostly occurs due to any trauma caused, while surgically operating on the salivary glands parotids very infrequently, infants and newborns have also been observed to develop this condition.
All structured data from the file and property namespaces is available under the creative commons cc0 license. Sweating on one side of the forehead, face, scalp, and neck that occurs soon after ingestion of food, as a result of damage to a nerve that goes to the large saliva gland in the cheek the parotid gland. Freys syndrome may affect any individual regardless of age, sex, racial, or ethnic inclination. Freys syndrome is a syndrome that includes sweating while eating gustatory sweating and facial flushing. Permanent treatment is available in the form of reconstructive surgery. Freys syndrome is secondary to the sympathetic denervation of sweat glands the reinnervation through the auriculotemporal nerve is a secondary event. Freys syndrome genetic and rare diseases information. In conclusion, the present case report has described the development of frey syndrome after a. Alvarez cuesta c, rodriguez diaz e, garcia bernardez am.
Summary frey syndrome or auriculotemporal nerve syndrome manifests as flushing, sweating, or both, localized to the distribution of the. As soon as the patient ate a lemon wedge, his left auricular and parotic regions became flushed and sweaty arrow, panel b. Freys syndrome, or auricotemporal syndrome leads to facial flushing and a rash associated with eating certain foods. Objective quantification of freys syndrome gustatory sweating, following total parotidectomy. Adm is a soft tissue matrix graft that is generated by decellularization of tissue that results an intact extracellular sgndrome.
The main symptoms of frey syndrome are undesirable sweating and flushing occurring on the cheek, temple. Frey syndrome fs is a localized cervicofacial hyperhidrosis and erythema during mastication in the preauricular area, which corresponds to the region of distribution of the auriculotemporal nerve. New surgical techniques have been proposed to avoid this complication, but are not widely in use. Freys syndrome is a disorder in which a strong salivary response is replaced by sweating and reddened skin on certain parts of the face. A biosensoring method of enzymatic electrodes enabling the detection of llactate on intact skin with the use of a skin extraction device and enzymatic electrodes is presented and analyzed design. In this case report, we highlight the clinical and psychosocial aspects of frey syndrome from a.
Dizon mv, fisher g, joopmckay a, treadwell pw, paller a. Frey syndrome is usually secondary to traumatic injury in the parotid region and is thought to be the result of misdirected resprouting of damaged autonomic nerve fibres. Freys syndrome as a differential diagnosis for food. If treatment is required, the most effective treatment has been subcutaneous in. Frey syndrome, also known as auriculotemporal syndrome or gustatory sweating, is probably the most frequent sequela of parotidectomy. Frey syndrome is manifested clinically by hemifacial flushing and sweating after a gustatory stimulus. Freys syndrome uncountable a rare neurological disorder resulting from damage to the parotid glands or auriculotemporal nerve, with symptoms including redness and sweating on the cheek. Frey syndrome was first described by baillarger in 1853.
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