A reevaluation of the Frey syndrome following parotid surgery.

The Frey syndrome, or gustatory sweating, is an accepted complication of parotid gland surgery that may occur with varying degrees of secerity. Since misdirection of auriculotemporal secretomotor nerve fibers has been found to play an important role in the development of the syndrome, a study was initiated to attempt mechanical interference with the regenerating fibers of the nerve. A superiorly based muscle flap from the sternocleidomastoid muscle was developed to cover the operative wound after either partial or complete parotidectomy. Results in 35 patients with such a muscle flap were compared with those in 35 control patients for the presence of absence of the Frey syndrome; the muscle flap was shown to be ineffective in preventing occurrence of gustatory sweating. Moreover, gustatory sweating to varying degrees was present in 34 patients with the muscle flap and in 33 control patients. Also, only 23 of the 70 patients had subjective complaints related to the syndrome, none of whom was incapacitated ore required additional measures for care.