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PubMed1992

Frey's syndrome: prevention with conservative parotidectomy and superficial musculoaponeurotic system preservation.

Between 1980 and 1990, 35 patients underwent conservative parotidectomy combining a rhytidectomy incision and a superficial musculoaponeurotic system preservation technique to reduce the postoperative incidence of Frey's syndrome. All patients were evaluated by questionnaire for subjective symptoms of gustatory sweating and flushing as well as satisfaction with the aesthetic appearance of their cheek. Six percent of patients (2 of 35) complained of symptoms of Frey's syndrome. Ninety-four percent of patients (33 of 35) noticed minimal or no contour deformity of the surgical area. Twenty patients underwent Minor's starch iodine testing to identify objective evidence of aberrant nerve regeneration at the postoperative site. Fifteen percent of these patients (3 of 20) demonstrated a positive starch iodine test; however, one of these three patients was unaware of symptoms of Frey's syndrome. Symptoms of gustatory sweating are a reliable indicator of aberrant nerve regeneration. Conservative parotidectomy with superficial musculoaponeurotic system preservation for benign parotid disease produces a low incidence of Frey's syndrome and satisfactory cosmetic results.

Adenoma, Pleomorphic↗
PubMed2005

[A retrospective study on the complications after modified parotidectomy in benign tumors of parotid gland].

OBJECTIVE: A retrospective clinic study is presented of surgical patients undergoing a modified parotidectomy with conserving the sub-superficial musculoaponeurotic system (sub-SMAS) and great auricular nerve and reconstructing by the stemocleidomastoid flap (SF). The incidence of clinical complications was observed after the parotidectomy. METHODS: 226 patients were divided randomly into four groups. Group 1 (94 cases) were operated by the conserving the sub-SMAS. Group 2 were operated by the sub-SMAS and constructed by SF. Group 3 (57 cases) were treated by the subcutaneous flap (sub-CF). Group 4 (33 cases) were received by sub-CF and SF. The surgical technique was described and the incidence of clinical Frey's syndrome was evaluated by minor test (starch-iodine test) and observed gustatory sweating syndrome. The feeling and concave of the region of auricular lobule were followed up. RESULTS: The incidence of Frey's syndrome in group 1 (5.32%) or group 2 (4.76%) was significantly lower than that of group 3 (49.1%) or group 4 (51.5%) through by subjective observation and minor test (P < 0.005). The significance between group with SF and group without SF existed in protecting the concave of the region of auricular lobule (P < 0.05). The feeling of the region of auricular lobule had no change by preserving the great auricular nerve. CONCLUSION: There was good effect to prevent gustatory sweating syndrome in parotidectomy of reserve parotid fascia. The aesthetics and sense of the region of auricular lobule could be prevented by using SF and reserving the great auricular nerve.

Face↗
PubMed2004

Quality of life following parotidectomy for malignant and benign disease.

Parotidectomy is performed for benign or malignant tumors and for selected benign inflammatory and autoimmune conditions. Possible associated complications include facial nerve paralysis, pain, loss of sensation, gustatory sweating, and facial scarring. Global quality of life in patients undergoing parotidectomy has not been reported. The implications of facial surgery with the catastrophic potential of facial nerve paralysis may severely affect quality of life. A quality-of-life study was conducted in patients undergoing parotidectomy for benign and malignant diseases to define the significance of associated morbidity and its impact on quality of life. A quality-of-life instrument was specifically created, based on the principles of the University of Washington Quality of Life questionnaire, and mailed to the patients. Questions addressed recognized complications of parotidectomy. Patient group results were compared for age above and below 45 years, sex, benign versus malignant disease, presence or absence of Frey syndrome, and presence or absence of benign pleomorphic adenoma. Forty-six percent of 125 patients meeting the study criteria fully replied to the questionnaire. The global health score was 3.5, corresponding with "good" to "very good." Except for local sensation, which had a score of 50, all other domains scored above 76. Change in appearance, gustatory sweating, and pain were reported by 70 percent, 57 percent, and 30 percent, respectively. Importance attributed to all domains except facial function was low. Pain was encountered significantly less in patients younger than 45 years of age, and scores for appearance were also highly significant in this age group. Postoperative sequelae were noted in the majority of patients. The dominant sequelae were altered sensation, change in appearance, Frey syndrome, and pain. A degree of permanent postoperative facial nerve impairment was reported by 10 patients. Nevertheless, overall, parotidectomy does not seem to severely affect quality of life.

Adult↗
PubMed1999

Video assistance reduces complication rate of thoracoscopic sympathicotomy for hyperhidrosis.

BACKGROUND: Thoracoscopic sympathicotomy has proved successful in the treatment of palmar hyperhidrosis. However, up to 8% of patients experience Horner's syndrome, and about 50% show compensatory sweating. This study evaluates the role of video assistance in thoracoscopic sympathicotomy for primary hyperhidrosis of the upper limb. METHODS: Six hundred fifty-six thoracoscopic sympathicotomies were performed from below T1 to T4 in 369 patients. Of the operations, 558 were done under direct view (CTS group) and 98, with video assistance (VATS group). Follow-up was complete for 78.3% of patients after a median observation period of 16 years. RESULTS: Dry limbs were immediately achieved in 93% of the CTS group and 98% VATS group (p = 0.98). In the CTS group, Horner's syndrome occurred after 2.2% of all operations and rhinitis in 8.3%. No patient in the VATS group showed any symptom of Homer's triad (p = 0.03 versus CTS group) or rhinitis (p = 0.02 versus CTS group). Compensatory sweating was observed in 66.8% in the CTS group versus 69% in the VATS group (p = 0.73) and gustatory sweating, in 50.4% versus 27.6%, respectively (p = 0.01). CONCLUSIONS: In performing thoracoscopic sympathicotomy for excessive upper-limb hyperhidrosis, we observed a significant decrease in the incidence of Horner's syndrome, rhinitis, and gustatory sweating when the procedure was guided by video imaging.

Adolescent↗
PubMed2004

Severity of compensatory sweating after thoracoscopic sympathectomy.

BACKGROUND: Compensatory sweating is a well-known side effect after sympathectomy for hyperhidrosis. It is often claimed to correlate with the extent of sympathectomy, but results from the literature are conflicting, and few have actually considered differences in the intensity of compensatory sweating. METHODS: A total of 158 patients underwent thoracoscopic sympathectomy for primary hyperhidrosis or blushing, or both. Sympathectomy was performed bilaterally at Th2 for facial hyperhidrosis/blushing (n = 49), Th2-3 for palmar hyperhidrosis (n = 62), and Th2-4 for axillary hyperhidrosis (n = 47). RESULTS: Follow-up by questionnaire was possible in 94% of patients after a median of 26 months. Compensatory sweating occurred in 89% of patients and was so severe in 35% that they often had to change their clothes during the day. The frequency of compensatory sweating was not significantly different among the three groups, but severity was significantly higher after Th2-4 sympathectomy for axillary hyperhidrosis (p = 0.04). Gustatory sweating occurred in 38% of patients, and 16% of patients regretted the operation. CONCLUSIONS: Compensatory and gustatory sweating were remarkably frequent side effects after thoracoscopic sympathectomy for primary hyperhidrosis. We found no significant difference between the level of sympathectomy and the occurrence of compensatory sweating. However, it appears that this is the first study to demonstrate that severe sweating is significantly more frequent after Th2-4 sympathectomy for axillary hyperhidrosis. We encourage informing patients thoroughly about these side effects before surgery.

Adolescent↗
PubMed2001

Efficacy and safety of thoracoscopic sympathicotomy for hyperhidrosis of the upper limb. Results of 734 sympathicotomies.

BACKGROUND: Thoracoscopic sympathicotomy (TS) evolved as treatment of choice in severe hyperhidrosis. The aim of this study was to assess the role of video-assistance in TS (VATS) versus conventional TS (CTS) for primary hyperhidrosis of the upper limb with regard to safety, side-effects and long-term outcome. METHODS: 734 TS were performed from below T1 to T4 in 406 patients. In the CTS and in the VATS group 558 and 176 procedures were performed, respectively. Follow-up was completed in 82% of all patients after a median observation period of 16 years. RESULTS: Dry limbs were immediately achieved in 92% (CTS) and 97% (VATS, p = 0.98). Only one patient (CTS) underwent conversion due to bleeding. In the CTS group Horner's syndrome occurred in 2.2% and rhinitis in 9.9% of procedures. No patient of the VATS group experienced Horner's syndrome (p = 0.025), 3 patients developed rhinitis (p = 0.11). At follow-up compensatory sweating was observed in 67.6% vs. 55.6% (p = 0.051) and gustatory sweating in 50.4% and 33.3% (p = 0.01). There were 5 failures or recurrences (1.9%) in the CTS group and 2 (2.8; p > 0.05) in the VATS group at reevaluation. Overall 6.5% (CTS) and 5.6% (VATS) of patients regret the operation (p = 0.7). CONCLUSIONS: We observed a significant decrease of the incidence of complete or incomplete Horner's syndrome and gustatory sweating when the procedure was guided by video-imaging while success rate was similar when compared with CTS.

Adult↗
PubMed1983

[Physiopathologic aspects and clinical pictures in hyperhidrosis].

Fully developed eccrine glands distributed over the entire integument are found only in man. The secretory mechanism is based on the active transport of sodium ions; water diffuses passively following the osmotic gradient. The thermoregulatory center in the hypothalamic region receives impulses from external and internal thermoreceptors and is modified by levels of hormones, by emotions, physical activity and pyrogens. Heat loss is controlled by the blood flow through the skin and by activity of eccrine glands. Thermoregulatory sweating occurs mainly on head and trunk. Emotions trigger eccrine sweating predominantly in the axillae, on palms, and soles. Generalized hyperhidrosis is mostly due to metabolic or endocrinologic disorders; in the state of acclimatization or following menopause hyperhidrosis is conceived to be physiologic. In underlying neurologic disorders hyperhidrosis follows a segmental or irregular pattern. Functional or anatomic eccrine nevi have been described. Gustatory sweating elicited by certain foods is found to be idiopathic and occurs symmetrically on the face. Subsequent to neurologic lesions (e.g., Frey's syndrome) gustatory sweating in segmental distribution may be associated with salivation and can be triggered by any foodstuff. The idiopathic localized hyperhidrosis of axillae, palms, and soles poses a frequent therapeutic problem in the dermatologist's office. Frequently, a familial predisposition is found. To what extent the disorder may be part of a general imbalance of psychovegetative functions is not yet fully understood.

Body Temperature Regulation↗
PubMed1992

Endoscopic transthoracic sympathectomy for idiopathic upper limb hyperhidrosis.

A 5-year experience of 51 endoscopic transthoracic dorsal sympathectomies for idiopathic palmar hyperhidrosis in 26 patients is presented. Fifty-two percent complained of excessive sweating over their hands, 28% of axillary sweating and 20% over both areas, with a mean duration of 10 years. The second, third and fourth thoracic ganglia and their interconnecting fibres on the affected side were ablated using diathermy cautery. Over a mean follow up time of 26 months, this procedure was successful in curing or improving intractable sweating in 92%. However, axillary sweating was less well controlled than in the palms with 20% of patients describing residual wetness in the axilla. Compensatory sweating (75%) and gustatory sweating (48%) were the commonest side effects; despite this, most patients were satisfied with the functional and cosmetic outcome. Other complications included a temporary Horner's syndrome in one patient, a pneumothorax in the immediate post-operative period in another and a unilateral non-infective reactionary pleural effusion in a third. Two patients developed recurrence of palmar hyperhidrosis within 6 months of surgery. One has been successfully treated by re-operation on the affected side. All patients complained of mild to moderate interscapular chest pain which was easily controlled by non-steroidal anti-inflammatory agents, and resolved within 7-10 days post-operatively. The technique of endoscope transthoracic sympathectomy is effective, relatively simple to perform and usually requires only an overnight stay. It is recommended as the surgical treatment of choice for upper limb hyperhidrosis unresponsive to conservative measures.

Adolescent↗
PubMed1992

Endoscopic transthoracic sympathectomy in the treatment of hyperhidrosis.

A 5-year experience of 50 endoscopic transaxillary dorsal sympathectomies is presented. The procedure was successful in either curing or improving the symptoms of hyperhidrosis in the great majority of patients. The commonest side effects were compensatory sweating (75%) and gustatory sweating (48%); despite this, there was an extremely high level of patient satisfaction. Permanent Horner's syndrome did not occur. The procedure is effective, simple, cheap, and requires only an overnight stay; and is recommended as the method of choice for the surgical treatment of upper limb hyperhidrosis.

Adolescent↗
PubMed1973

Facial sweating after food: a new sign of diabetic autonomic neuropathy.

Facial sweating during eating (gustatory sweating) has been observed for the first time in a group of diabetics, and is considered to be a feature of the autonomic neuropathy which affected them all. The sweating, which was sometimes very severe, was produced by many foodstuffs, cheese being the most powerful stimulus. Atropine inhibited sweating stimulated by eating cheese, and oral anticholinergic drugs effectively eliminated the symptoms. These bizarre symptoms are probably due to abnormal nerve regeneration occurring as a consequence of the spontaneous autonomic neuropathy.

Adolescent↗
PubMed1998

Hyperhidrosis treated by botulinum A exotoxin.

BACKGROUND: Hyperhidrosis, or excessive sweating, can be emotionally challenging and socially and professionally disruptive, and there have been few effective treatments. Recently, botulinum toxin has been demonstrated to be an effective treatment for hyperhidrosis of the axillae and palms and for gustatory sweating. OBJECTIVE: This article reviews the current treatments and outcomes achieved with chemodenervation of the eccrine sweat glands. RESULTS: The antihydrotic response lasted 6-17 months for gustatory sweating, 2-8 months for axillary sweating, and 13 weeks to 12 months for palmar sweating. CONCLUSIONS: Intracutaneous injections of botulinum toxin offer a simple, safe, and effective alternative to other conservative and surgical options.

Botulinum Toxins, Type A↗
PubMed2006

[Thoracic sympathetic block by clamping in the treatment of primary hyperhidrosis: indications and results in 281 patients].

AIM: Hyperhidrosis is a disabling troublesome characterized by excessive perspiration that produces a significant social and professional deficit for patients. It main involves the palmar sides of hands and feet, axillae, face and, with a lesser incidence, trunk and scalp. Thoracoscopic sympathectomy represents the best approach for this disorder. The aim of our prospective study is to assess the outcome, the safety and efficacy after thoracoscopic sympathetic block by clipping in the treatment of primary hyperhidrosis. METHODS: Between september 2002 and april 2005, 281 patients (117 female and 164 male, with a mean age of 28 years) underwent Endoscopic Thoracic Sympathectomy (ETS) to treat hyperhidrosis with palmar, axillar, facial and widespread localization. RESULTS: There were no deaths or major intra-operative problems. There was no conversion to open surgery. During intermediate and long-term follow up we obtained excellent results and few complications. In 3 patients (1.06%) we noted a major complication (Horner's Syndrome), but one patient only had the surgical operation reversed; compensatory sweating occurred in 61 individuals (21.7%). Gustatory sweating occurred in no patient. CONCLUSIONS: The clipping of the thoracic sympathetic chain is a reversible surgical technique considered safe and effective. Despite of an incidence of complications and/or compensatory sweating and according to our operatory results, we conclude that the sympathetic block by clamping is the elective treatment for hyperhidrosis.

Adolescent↗
PubMed2004

Botulinum toxin treatment of secretory disorders.

Botulinum neurotoxin serotype A (BoNT/A) has revolutionised the treatment of a variety of autonomic hypersecretory disorders. Several open and controlled studies indicate that BoNT/A is a safe and effective treatment for focal hyperhidrosis of the axillae and palms, for gustatory sweating, and for some other rare conditions associated with focal hyperhidrosis. There is class I evidence for the efficacy of botulinum toxin in axillary hyperhidrosis and class II evidence for palmar hyperhidrosis and gustatory sweating. BoNT/A has the potential to replace current invasive and surgical techniques and should at least be considered as a viable alternative. The results of pilot studies to treat sialorrhea are encouraging. However, the optimal dose, best mode of application, side effects, and duration of BoNT/A action in this condition remain uncertain. We need further formal clinical trials to evaluate risks and benefits of BoNT/A for palliative treatment in of sialorrhea in Parkinson's disease and in bulbar amyotrophic lateral sclerosis. Based on the few reports published, BoNT/A injections into the lacrimal gland for hyperlacrimation may be an elegant method to treat this sometimes disabling condition. Again, larger studies are needed to evaluate the risks and long-term benefits of this treatment option.

Anti-Dyskinesia Agents↗
PubMed2000

[Post-parotidectomy Frey's syndrome. Treatment with botulinum toxin type A].

The Frey's syndrome, manifest after parotid trauma, is characterized by head and neck hyperemia and abundant sweating of the hyperemic skin in response to gustatory stimuli. The use of the botulin toxin to treat the symptoms in patients with Frey's syndrome has been described in numerous studies. For some time up until now our Center has achieved excellent results using the group A botulin toxin to overcome the hypertonus of the cricopharyngeal muscle in patients who had undergone laryngectomy and were rehabilitated with voice button. We have sought to extend the use of this toxin to Frey's syndrome, a relatively frequent complication of parotidectomy. A total of 86 patients participated in the study: 41 males (47.6%) and 45 females (52.4%) ranging in age from 25 to 77 years (average age 51 years). Of these patients 7 (8.1%) had undergone post-operative radiotherapy. Of the 86 patients studied, 18 referred significant symptoms in terms of abundance and frequency. The syndrome was considered severe if the symptoms were present at each meal and if the patient indicated a significant worsening of his quality of life. Intermittent episodes were indicated by 22 patients. The remaining 46 (43.5%) did not complain of any symptoms. The exact extension of the cervicofacial gustatory sweating was evaluated using the Minor test and the involved region was divided into 1 square centimeters sections. The amount of skin surface involved ranged from 10 to 80 square centimeters. The type A neurotoxin was frozen and was reconstituted with a sterile saline solution at a final concentration of 2.5 UI/0.1 ml. The intracutaneous infiltration was performed without anesthesia, infiltrating 0.1 ml of solution, containing 2.5 UI of toxin into the center of each 1 square centimeters section. Statistical analysis was performed to evaluate the potential relationship between how long the treatment was effective, incidence of recurrence, seriousness of the crises and the following variables: age, sex, histology, cutaneous surface involved, injected dose of botulin toxin and post-operative radiotherapy. In the group of 18 patients with severe symptoms (20.9%) the benefit was immediate in all cases although the recurrence rate was 50%. The Frey's syndrome symptoms disappeared within 7 days of infiltration. In the group of 22 patients with less severe involvement (25.5%), the treatment gave positive, definitive results in 16 patients (72.7%). Those patients whose symptoms persisted were treated a second time with an infiltration of 2.5 UI per square centimeters. We feel that the use of the type A botulin toxin is the most appropriate treatment for the Frey's syndrome. In fact, such treatment offers the following advantages: it is effective within 7 days, has limited side effects, can be applied on an outpatient basis, is inexpensive and is positively considered by the patients.

Adult↗
PubMed2001

Evidence-based medicine: botulinum toxin in focal hyperhidrosis.

All studies performed so far indicate that BTX-A is a safe and effective treatment for focal hyperhidrosis of the axillae and palms, for gustatory sweating, and for some other rare conditions associated with focal hyperhidrosis. Based on two large well-designed, double-blind, placebo-controlled study there is class 1 evidence for the efficacy of BTX-A in axillary hyperhidrosis, and class 2 evidence for BTX-A in gustatory and palmar sweating (classification according to the Quality Standards Subcommittee of the American Academy of Neurology, 1994). Other indications (forehead sweating, plantar hyperhidrosis, truncal sweating) are only anecdotally reported.

Animals↗
PubMed2003

Sympathectomy for neuropathic pain.

BACKGROUND: Neuropathic pain is defined as pain initiated or caused by a primary lesion or dysfunction in the nervous system. Some examples of this condition are phantom limb pain, post-stroke pain and complex regional pain syndrome type I (reflex sympathetic dystrophy) and type II (causalgia). Treatment options include drugs, physical treatments, surgery and psychological interventions. The concept that many neuropathic pain syndromes, particularly RSD and causalgia are "sympathetically maintained pains" has historically led to attempts to temporarily or permanently interrupt the sympathetic nervous system. Chemical sympathectomies use alcohol or phenol injections to destroy the sympathetic chain, but this effect is temporary until regeneration of the sympathetic chain occurs. Surgical ablation can be performed by open removal or electrocoagulation of the sympathetic chain, or minimally invasive procedures using stereotactic thermal or laser interruption. OBJECTIVES: The review aimed to assess the effects of both chemical and surgical sympathectomy for neuropathic pain. Secondary objectives were to compare the effects of sympathectomy with no treatment, placebo or conventional treatment, and to evaluate whether the technique of sympathectomy influences the outcomes of the procedure. SEARCH STRATEGY: We searched MEDLINE and EMBASE up to February 2003 and the latest issue of the Cochrane Library (Issue 1, 2003). We screened references in the retrieved articles, literature reviews and book chapters. We also contacted experts in the field of neuropathic pain. SELECTION CRITERIA: Clinical trials and observational studies assessing the effects of sympathectomy (surgical or chemical) for neuropathic pain of both central or peripheral origin were included. DATA COLLECTION AND ANALYSIS: Two reviewers applied the selection criteria to titles and abstracts. Full articles of potentially eligible trials were obtained and the same reviewers applied the inclusion criteria to the studies. The methodological quality of the studies was evaluated. The studies were also evaluated for clinical relevance according to a classification developed by our group. Statistical pooling was not possible due to heterogeneity of data; instead a narrative description of each included study was performed. MAIN RESULTS: We included four studies. One randomized trial comparing radiofrequency sympatholysis with phenol sympathectomy was rated as low methodological quality and it showed that radiofrequency sympatholysis does not offer advantage over phenol techniques. However, a modified technique produced sympatholysis comparable to that produced by 6% phenol, with less incidence of post-sympathectomy neuralgia. REVIEWER'S CONCLUSIONS: The practice of surgical and chemical sympathectomy is based on poor quality evidence, uncontrolled studies and personal experience. Furthermore, complications of the procedure may be significant, in terms of both worsening the pain or producing a new pain syndrome; and abnormal forms of sweating (compensatory hyperhidrosis and pathological gustatory sweating). Therefore, more clinical trials of sympathectomy are required to establish the overall effectiveness and potential risks of this procedure.

Humans↗
PubMed1996

Endoscopic versus transaxillary thoracic sympathectomy for primary axillary and palmar hyperhidrosis and/or facial blushing: 5-year-experience.

Thoracic sympathectomy is effective in the permanent cure of primary axillary and palmar hyperhidrosis and facial blushing, which can be so troublesome for patients that their social and professional relations can be affected. Between October 1988 and April 1994, a total of 50 thoracic sympathectomies (10 surgical and 40 endoscopic) were performed on 5 and 23 patients, respectively. The operations were performed unilaterally, followed by the contralateral intervention after a period of 6-8 weeks. The thoracic ganglia T2-T5 were resected for hyperhidrosis. If the patient suffered from blushing, the lower 1/3 of the stellate ganglion was also resected. Postoperatively, all the operated limbs were warm and dry. In the group of patients who were operated bilaterally, only one had persistent facial blushing. The efficacy for blushing in this series was therefore 93.3%. The late relapse rate of sympathetic activity was 14.3%. Compensatory sweating was seen in 67%, gustatory sweating in 37.5% and phantom sweating in 29% of the patients. None of them considered these side effects to be troublesome. Although there is no difference between transaxillary thoracic sympathectomy and the endoscopic intervention in terms of efficacy, the latter is associated with less postoperative pain, shorter hospital stay and a rapid recovery. The thoracic sympathectomy is the treatment of choice for primary hyperhidrosis and excessive facial blushing.

Adult↗
PubMed1997

Localized facial flushing in infancy. Auriculotemporal nerve (Frey) syndrome.

BACKGROUND: Patients with auriculotemporal nerve syndrome (Frey syndrome) have facial flushing, sweating, or both localized to the distribution of the auriculotemporal nerve that occurs in response to gustatory stimuli. In adults, the syndrome usually results from surgical injury or trauma to the parotid gland. The condition is rare in infants, but usually manifests during infancy with the introduction of solid food, thus leading to the misdiagnosis of food allergy by physicians unfamiliar with the syndrome. OBSERVATIONS: We describe 8 children with auriculotemporal nerve syndrome who manifested with flushing only. The reaction was erroneously attributed to food allergy in most cases. Six of the 8 patients were delivered with forceps assistance. The remaining 2 patients, with disease onset during the first 3 months of life, had bilateral involvement without known trauma. CONCLUSIONS: Auriculotemporal nerve syndrome may manifest during infancy as flushing with eating food. In contrast to the syndrome in adults, gustatory sweating is rarely associated. The known use of forceps to assist in the delivery of at least 14 of the 28 previously reported pediatric cases and in 6 of our 8 patients suggests that trauma to the parotid region may be responsible for the condition in most infants, as it is in adults. Auriculotemporal nerve syndrome in infancy should be recognized as a benign condition that often resolves spontaneously. Treatment is ineffective and unnecessary.

Birth Injuries↗