Frey's syndrome and parotid surgery

1998 ◽  
Vol 23 (4) ◽  
pp. 291-301 ◽  
Author(s):  
S. Sood ◽  
M. S. Quraishi ◽  
P. J. Bradley
Keyword(s):  
Frey’S Syndrome ◽  
Parotid Surgery ◽  
Frey's Syndrome

Prevention of Frey’s Syndrome with the Use of Porcine Dermal Collagen Graft: Retrospective Analysis of 76 “Formal” Parotidectomies for Benign Pathologies

2021 ◽  
pp. 000348942199018
Author(s):  
Kostas Vahtsevanos ◽  
Angelos Chatziavramidis ◽  
Ioannis (Yiannis) Papadiochos ◽  
Georgios Koloutsos ◽  
Anastasios Stefanidis ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Frey’S Syndrome ◽  
Randomized Controlled Studies ◽  
Parotid Surgery ◽  
Porcine Dermal Collagen ◽  
Frey's Syndrome ◽  
Dermal Collagen ◽  
Group A ◽  
Group B ◽  
Collagen Graft

Background: Frey’s syndrome is a well-known complication of parotid surgery; its prevention may be achieved by the use of an interpositional barrier between the overlying flaps and the exposed parenchymal bed of parotid gland. The aim of this study was to retrospectively evaluate clinical outcomes with and without the interpositional placement of a porcine dermal collagen graft (PDCG) for prevention of syndrome occurrence. Methods: We conducted a 20-year retrospective study including the patients who had undergone “formal” (superficial, total, or subtotal) parotidectomies for benign pathologies. The inclusion criteria also involved patients that were (i) regularly monitored about clinical symptoms related to syndrome, and (ii) examined with Minor starch-iodine test. The severity of the diagnosed syndrome was retrospectively evaluated according to the grading score system of Luna-Ortiz. To assess group differences in terms of the extent of dissection in operating sites, we estimated the tumor and histological specimen volumes using the available dimensions. Results: We included 73 patients who had undergone 76 formal parotid surgeries. The surgical sites were divided into 2 groups: (1) Group A consisted of 44 sites that were reconstructed with a SMAS flap, and (2) Group B, comprised 32 sites where a PDCG was additionally applied as an artificial preventive barrier. At a mean follow-up of 26.3 months, a significantly lower incidence of clinically diagnosed Frey’s syndrome was found after the use of dermal collagen interpositional barrier ( P = .031). Specifically, subjective symptoms were reported at an incidence of 31.8% in Group A and 6.7% in Group B. Minor’s test was positive at an incidence of 59.09% in Group A and 21.87% in Group B ( P = .004, 95% CI). Severe Frey’s syndrome was observed in 31.82% of the patients of Group A and in 3.12% of the patients of Group B ( P = .002, 95% CI). Since there were no statistical significant differences between the volumes of the removed tumors and the excised histological specimens, the extent of dissection was not proved to influence the occurrence of Frey’s syndrome in the compared groups, Conclusion: Porcine dermal collagen is a safe, practical, and useful means for parotid reconstruction, since it seems to contribute in prevention of Frey’s syndrome when increased amount of glandular tissue has to be removed. Additional randomized controlled studies with bigger samples are required to better assess the PDCG use in parotid surgery.

Innovative Technique to Reduce Incidence of Frey's Syndrome after Parotid Surgery

2011 ◽  
Vol 77 (3) ◽  
pp. 351-354 ◽  
Author(s):  
Neeraj Singh ◽  
Monica Kohli ◽  
Harjeet Kohli
Keyword(s):  
Absolute Risk ◽  
Absolute Risk Reduction ◽  
Control Group ◽  
Regenerated Cellulose ◽  
P Value ◽  
Frey’S Syndrome ◽  
Exact Test ◽  
Parotid Surgery ◽  
Frey's Syndrome ◽  
Aberrant Regeneration

Frey's syndrome was first described by Lucia Frey, a Polish neurologist in 1923. It is well accepted that it involves injury to the branches of the auriculotemporal nerve with subsequent aberrant regeneration. Due to this abnormal communication, the skin glands and vessels are always stimulated at the same time as eating and mastication, which results in symptoms such as flushing and sweating. The incidence of Frey's syndrome in the literature has been variously described from 6 to 96 per cent. We analyzed the chart of 18 patients who had parotidectomy from March 2002 to December 2009. All procedures were performed by a single surgeon at the same facility. A total of 16 superficial and three total parotidectomies were done; one patient had bilateral parotidectomy. Oxidized regenerated cellulose (Interceed) was used after 10 surgeries (study group) and no adjuvant was used after nine surgeries (control group). All of the surgeries were done using similar technique. All the patients were followed-up with for a period of about 6 months postoperatively. The absolute risk reduction associated with the placement of an Interceed was 11 per cent. The small number of cases (n = 19) and an empty cell limits statistical analysis (a Fisher's exact test revealed a P value of 0.44). Clearly the low number of procedures restricted the power to test these differences. The development of Frey's syndrome is a very disabling but under-reported complication. The placement of a temporary barrier like Interceed may help in the prevention of Frey's syndrome without increasing any complications.

Frey's syndrome: treatment with botulinum toxin

1997 ◽  
Vol 111 (9) ◽  
pp. 839-844 ◽  
Author(s):  
A. Bjerkhoel ◽  
O. Trobbe
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Surgical Techniques ◽  
Frey’S Syndrome ◽  
Need For Treatment ◽  
Gustatory Sweating ◽  
Parotid Surgery ◽  
Frey's Syndrome ◽  
Before And After ◽  
Set Up

AbstractFrey's syndrome, i.e. gustatory sweating on the cheek, is a fairly common embarrassment after parotid gland surgery. New surgical techniques have been proposed to avoid this complication, but are not widely in use. Hence, there is need for treatment of Frey's syndrome. All surgical and topical treatments have drawbacks. This study was set up in order to evaluate a recently described treatment. One hundred and two patients were interviewed after parotidectomy. Thirty-one of them had noticed gustatory sweating and 15 patients underwent Minor's starch iodine test before, and after, treatment with intracutaneous injections of botulinum toxin A (Botox®, Allergan Inc., USA). Thirteen of the patients did not experience any gustatory sweating at follow-up (one to 13 months). Minor's starch test showed total disappearance of gustatory sweating in 12 of the 15 treated patients. The only side effect was a discreet, transitory affection of the orbicularis oris muscle in one patient. As this treatment is minimally invasive it could be an attractive treatment for Frey's syndrome if the effect is maintained. Complaints of local hypoaesthesia and pain were also common after parotid surgery.

Frey's syndrome after parotid surgery

1976 ◽  
Vol 132 (1) ◽  
pp. 54-58 ◽  
Author(s):  
Angus B. Gordon ◽  
R.V. Fiddlan
Keyword(s):  
Frey’S Syndrome ◽  
Parotid Surgery ◽  
Frey's Syndrome

How can Frey's syndrome be prevented or treated following parotid surgery?

2013 ◽  
Vol 123 (7) ◽  
pp. 1573-1574 ◽  
Author(s):  
Robert L. Witt ◽  
Edmund A. Pribitkin
Keyword(s):  
Frey’S Syndrome ◽  
Parotid Surgery ◽  
Frey's Syndrome

Free fat grafting in superficial parotid surgery to prevent Frey's syndrome and improve aesthetic outcome

2013 ◽  
Vol 128 (S1) ◽  
pp. S44-S49 ◽  
Author(s):  
L S Chan ◽  
M S Barakate ◽  
T E Havas
Keyword(s):  
Clinical Symptoms ◽  
Case Series ◽  
Fat Grafting ◽  
Aesthetic Outcome ◽  
Frey’S Syndrome ◽  
Inexpensive Method ◽  
Benign Pathology ◽  
Parotid Surgery ◽  
Frey's Syndrome ◽  
Prospective Case Series

AbstractBackground:Frey's syndrome and cosmesis are important considerations in parotid surgery. Placement of an interpositional barrier can prevent these complications; however, surgical technique and efficacy remain controversial.Methods:A prospective case series was collected comprising all patients undergoing primary superficial parotidectomy for benign pathology with abdominal free fat grafting between June 2007 and December 2010, performed by a single surgeon. A survey was also distributed to otorhinolaryngology consultants across Australia to assess current practice.Results:Twenty-eight patients were included. No patient had clinical symptoms of Frey's syndrome. Seventy-five per cent of patients were completely satisfied with their aesthetic outcome, 18 per cent scored 4/5 and the remaining 7 per cent (2 patients) scored 3/5. The survey revealed that 79 per cent of respondents did not use interpositional grafts.Conclusion:Abdominal free fat is ideal for grafting as it is an effective, safe, simple, accessible, fast and inexpensive method of providing an interpositional graft.

FREY'S SYNDROME FOLLOWING PAROTID SURGERY

1991 ◽  
Vol 61 (4) ◽  
pp. 295-301 ◽  
Author(s):  
M. L. Farrell ◽  
I. K. Kalnins
Keyword(s):  
Frey’S Syndrome ◽  
Parotid Surgery ◽  
Frey's Syndrome

Association between skin flap thickness and Frey's syndrome in parotid surgery

Head & Neck ◽  
2013 ◽  
Vol 35 (12) ◽  
pp. 1781-1786 ◽  
Author(s):  
Osman Durgut ◽  
Oguz Basut ◽  
Uygar Levent Demir ◽  
Ömer A. Özmen ◽  
Fikret Kasapoglu ◽  
...  
Keyword(s):  
Skin Flap ◽  
Frey’S Syndrome ◽  
Parotid Surgery ◽  
Frey's Syndrome ◽  
Flap Thickness

scholarly journals Assessment of functional outcome after parotidectomy reconstruction

2018 ◽  
Vol 4 (3) ◽  
pp. 780 ◽  
Author(s):  
Jitendra Kumar ◽  
Sunil Kumar ◽  
H. P. Singh ◽  
Veerendra Verma ◽  
Anupam Mishra
Keyword(s):  
Muscle Flap ◽  
Neck Surgery ◽  
Sternocleidomastoid Muscle ◽  
Frey’S Syndrome ◽  
Patient’S Satisfaction ◽  
Number Of Patients ◽  
Parotid Surgery ◽  
Frey's Syndrome ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Total or superficial parotidectomy, when a reconstructive technique is not used, usually leads to Frey’s syndrome, preauricular and retromandibular depression. These together with the scar from a classic or modified Blair incision limit the final aesthetic outcome. The superiorly based sternocleidomastoid muscle (SCM) flap or superficial musculo-aponeurotic system (SMAS) flap can be used for reconstruction of the defect to achieve better facial contour restoration. The aim and objective of the study was to evaluate the functional and cosmetic outcome of patients after reconstruction in parotid surgeries.</p><p class="abstract"><strong>Methods:</strong> This study was done in the department of Otorhinolaryngology &amp; Head-Neck Surgery. Total number of patients with parotid tumours were 24 in each group namely- Group A: Patients undergoing parotid surgery without reconstruction. Group B: Patients undergoing parotid surgery with reconstruction using superiorly based sternocleidomastoid muscle flap. All patients were followed and analyzed on 6 weeks, 6 months and 1 year postoperatively on the basis of patient’s satisfaction, cosmesis, subjective Frey’s syndrome, retromandibular and pre-auricular depression using visual analogue scale.  </p><p class="abstract"><strong>Results:</strong> In Group A, subjective Frey’s syndrome was present in 8.3% patients from 6 month to 1 year. In contrast, in Group B, it remain absent in all patients at all periods. In Group A, preauricular depression was present in 79.2% patients in immediate postop and 95.8% patients from 6 week to 1 year. In contrast, in Group B, it was present in only 4.2% patients at all periods. In Group A, retromandibular depression was present in 70.8% patients while in Group B, it was absent in all patients.</p><p class="abstract"><strong>Conclusions:</strong> The superiorly based SCM flap for reconstruction of defect following superficial or total parotidectomy improves the final outcome in terms of the facial deformity (pre-auricular, retro-auricular depression) and lowers the incidence of Frey’s syndrome.</p>

Sign in / Sign up

Export Citation Format

Share Document