Frey Syndrome — ORE Part 1 MCQ

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HardOral SurgeryFrey SyndromeORE Part 1

A 60-year-old man undergoes superficial parotidectomy for a parotid tumour. Several months later, he notices sweating and flushing of the preauricular skin when eating. Which postoperative complication is most likely?

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Correct answer: D — Frey syndrome

The answer is D: Frey syndrome. This is gustatory sweating, often with flushing, over the preauricular/parotid region after parotid surgery. It follows aberrant regeneration of autonomic fibres, such that salivary stimulation during eating also activates cutaneous sweat glands and vessels. First-bite syndrome is the key distractor: it can occur after parotid-region surgery but causes severe pain in the parotid region with the first mouthful of a meal, rather than sweating or flushing. Sjögren syndrome produces xerostomia and dry eyes. Bell palsy is a lower motor neurone facial weakness, while Ramsay Hunt syndrome is varicella-zoster infection involving the facial nerve, typically with otalgia and vesicular eruption.

Reference: Mantelakis A, et al. Frey's Syndrome: A Review of Aetiology and Treatment. Cureus. 2021. https://pubmed.ncbi.nlm.nih.gov/34873562/