Etiologyįrey syndrome usually occurs in adults with auriculotemporal nerve injury due to surgical manipulation or trauma in the parotid region. Peter Bassoe reported the first case of Frey syndrome after a parotidectomy, which has since become the most common cause of the condition. Andre Thomas theorized that the pathophysiology of the disease involved aberrant nerve regeneration. She accurately identified the autonomic innervation of the parotid gland and the auriculotemporal nerve as the link between gustatory stimulation and facial sweat production. She described a 25-year-old female who sustained a gunshot wound to the parotid region and subsequently developed facial flushing and sweating five months afterward. Lucja Frey, a Polish physician and one of the first female academic neurologists in Europe. It was not until 1923 that the first accurate description of this phenomenon was provided by Dr. Then, in 1897, Weber described bilateral gustatory sweating and flushing in a patient who had undergone bilateral parotid abscess drainage, the first reported case of bilateral Frey syndrome. Previously, Dupuy had described gustatory sweating over the cheek area in relation to experimental sectioning of cervical sympathetic nerves in horses around 1816.
FIRST BITE SYNDROME CURE SKIN
At that time, he misinterpreted the facial fluid as saliva overflowing through the skin due to a blocked Stenson’s duct. The patients later developed facial sweating during meals. Jules Baillarger first reported the phenomenon in 1853, describing two patients that underwent incision and drainage for parotid abscesses. Frey syndrome most commonly arises as a complication of parotidectomy, but can also be associated with submandibular gland surgery, repair of mandibular fractures, temporomandibular joint injury, neck lymph node dissection, infection, and trauma to the parotid region. Symptoms occur during meals, especially with spicy and sour foods. Patients with Frey syndrome often present with facial warmth, flushing, and sweating in the territory of the auriculotemporal nerve overlying the parotid gland, which may include the preauricular skin, the temporal skin, the scalp, and the temporomandibular joint region. When an insult to the parasympathetic and sympathetic nerve fibers of the auriculotemporal nerve in the parotid region occurs, the resulting aberrant regeneration of post-ganglionic parasympathetic nerve fibers (responsible for salivary secretion) along the pre-existing sympathetic pathways to the vessels and sweat glands of the skin leads to the development of Frey syndrome. The auriculotemporal nerve, a branch of the trigeminal nerve, consists of parasympathetic fibers that signal the parotid gland to produce saliva and sympathetic fibers that innervate the sweat glands of the face and scalp. Describe interprofessional team strategies for improving care coordination and communication in the management of patients with Frey syndrome.įrey syndrome, also known as Baillarger’s syndrome, auriculotemporal syndrome, Dupuy syndrome, or gustatory hyperhidrosis, represents aberrant reinnervation following injury to the auriculotemporal nerve.Review the management options available for Frey syndrome.Review the critical elements of the evaluation of the patient with Frey syndrome.This activity reviews the evaluation and treatment of Frey syndrome and highlights the role of the interprofessional team in the care of patients with this condition. Though not always achievable, the prevention of this common complication is preferable to treatment prompt diagnosis and management will substantially improve patient quality of life. Frey syndrome usually occurs with auriculotemporal nerve injury as a result of surgical intervention or trauma in the parotid region.
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