Frey's syndrome is a disorder in which a strong salivary response is replaced by sweating and reddened skin on certain parts of the face. This reaction occurs typically as a response to foods that generally cause extreme salivation and most often it is not associated with pain. It was first noted in 1923 by a Polish doctor named Lucie Frey. Baillarger's syndrome, Frey-Baillarger's syndrome and auriculotemporal syndrome are also common names for the same disorder. It is a condition
The onset of Frey's syndrome often occurs following removal of, or surgery on, the parotid glands. These glands are the largest salivary glands in the body and are situated in front of the ears. It is the parotid glands that secrete saliva into the mouth. In some cases, an injury may also cause Frey's syndrome.
When a person is injured or has surgery on these glands, nerves that connect to it may be damaged. Often a nerve called the auriculotemporal nerve is damaged; however, postganglionic parasympathetic nerve fibers leading to the parotid gland may also be damaged during surgery. If this occurs these nerves may erroneously unite with the nerves that lead to the sweat glands. As a result, instead of stimulating a salivary response to food, the sweat glands are stimulated and the person begins to sweat as a response.
Sweating may appear along the cheeks, on the forehead, scalp and neck. In addition, a person with Frey's syndrome will also notice redness on his face, at the cheeks. This redness will usually extend to the back of the ears as well. These symptoms occur when eating foods that typically stimulate a salivary response. The smell of certain foods, as well as seeing or even discussing foods that would normally cause salivation, may also trigger this response in people with this condition.
It is usually unnecessary to conduct any form of testing to diagnose Frey's syndrome. If there is a question regarding the accuracy of the diagnosis, a test called a starch iodine test may be conducted. This involves placing iodine on the skin that is directly in front of the ear. Powdered starch is then placed over the dry iodine. The patient is stimulated by the sight or taste of food and if the iodine darkens beneath the starch, it is considered a positive test for the condition.
Treating Frey's syndrome is often unnecessary as the symptoms are more of an annoyance than a health problem. Most methods of treatment only provide temporary relief and are not cures for the condition. One of the most common and longest lasting forms of treatment is botulism toxin injections. A patient who has this disorder may also choose to use an antiperspirant to lessen the appearance of sweat. In extreme cases, these symptoms can be severe enough to warrant further measures and surgery may be considered an option.
