CLINICAL REVIEW Mark K. Wax, MD, Section Editor MANAGEMENT OF FREY SYNDROME

Abstract: Almost all patients who undergo parotidectomy will to some extent develop Frey syndrome (auriculotemporal syn-drome or gustatory sweating) after surgery, because of aberrant regeneration of cut parasympathetic fibers between otic gan-glion and subcutaneous vessels. However, only the minority of these patients needs treatment. The syndrome consists of gus-tatory sweating, flushing, and warming over the preauricular and temporal areas. Thick skin flap and partial superficial parotidec-tomy are the most important techniques to minimize the risk of developing symptomatic Frey syndrome. Intracutaneous injec-tion of botulinum toxin A is an effective, long-lasting, and well-tolerated treatment of Frey syndrome. If recurrence occurs, the treatment can be repeated. VC 2007 Wiley Periodicals, Inc