Treatment of frey's syndrome

Abstract

Understand the anatomy of the autonomic innervation of the parotid gland and facial skin. Frey's syndrome is secondary to the sympathetic denervation of sweat glands - the reinnervation through the auriculotemporal nerve is a secondary event. The aberrant regeneration theory explains the physiopathology of Frey's syndrome; other described variants do not represent true Frey's syndrome cases. A topographic and quantitative testing for Frey's is required prior to its treatment - the ISPH test described has the majority of desired features. Frey's syndrome incidence after parotidectomy, without prevention techniques, is 40-80% by clinical questioning and 80-100% by objective testing. Intradermic botulinum toxin injection is a well-tolerated and efficient treatment. The recommended dilution is 50 IU/1 ml, inter-injection distance is 1 cm, and injection volume is 0.1 ml. © 2007 Springer-Verlag Berlin Heidelberg.