Frey’s Syndrome following Submandibular Gland Excision: An Unusual Postoperative Complication

Abstract

Gustatory sweating and flushing, or Frey’s syndrome, is a fairly common complication following surgery or injury to the parotid gland and is thought to be caused by aberrant nerve regeneration. A similar condition has been reported in the literature following surgery to the submandibular region. Since this was first described in 1934, only 7 subsequent cases of submandibular sweating and flushing have been reported. We present a case of a 52-year-old female who underwent excision of the left submandibular gland as a result of chronic sialadenitis. Twelve months following surgery, symptoms indicative of Frey’s syndrome were experienced in the operative region. A review of the aetiology and treatment of the condition is described.

Perioral gustatory sweating: case report

“…In such cases, a Frey-like syndrome of the skin in the submandibular region has been documented, termed the 'chorda tympani syndrome'. [12][13][14] Due to disruption of the chorda tympani, gustatory otorrhoea has also been described after modified radical mastoidectomy. 15,16 In our case, gustatory sweating occurred around the mouth and chin area.…”

“…Injury to the lingual nerve at the submandibular ganglion, along with the chorda tympani parasympathetic secretomotor branch of the facial nerve and sympathetic fibres, leads to aberrant reinnervation of sweat glands and blood vessels. In such cases, a Frey-like syndrome of the skin in the submandibular region has been documented, termed the ‘chorda tympani syndrome’ 12 – 14 . Due to disruption of the chorda tympani, gustatory otorrhoea has also been described after modified radical mastoidectomy 15 , 16 …”

Submandibular Frey Syndrome Following Submandibular Gland Excision

“…Systemic anticholinergics, such as atropine, have also been tried to control gustatory sweating. 6 However, Frey syndrome uncontrollable by medical therapy or needing long-term control may require surgical management.…”

“…Its relationship to the removal of the submandibular gland was reported in 6 cases of this syndrome. [1][2][3][4][5][6] A 35-year-old female visited with a 1-month history of a mass on her left submandibular area. She has no history of diabetes and no other remarkable medical history.…”

“…Its relationship to the removal of the submandibular gland was reported in 6 cases of this syndrome. 1 -6…”