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PubMed1995

Expanded polytef for reconstructing postparotidectomy defects and preventing Frey's syndrome.

An expanded polytef (polytetrafluoroethylene [ePTFE]) soft-tissue patch was used in nine patients to reconstruct postparotidectomy defects and prevent Frey's syndrome. All nine cases were constructed primarily using either a 1- or 2-mm-thick patch depending on the depth of the defect. All nine patients achieved excellent, nearly normal contour that approximates the uninvolved side. None complained of Frey's syndrome. Average follow-up to date is 12 months.

Biocompatible Materials↗
PubMed1981

Auriculotemporal syndrome in childhood.

Auriculotemporal syndrome, also known as Frey's syndrome, consists of the development of facial flushing or sweating over the distribution of the auriculotemporal nerve immediately following eating or drinking. It has been recognized in adults as a common postoperative complication of parotid-gland surgery or dorsal sympathectomy. The syndrome is uncommon in children. As its course is benign, it is important to recognize it, thus avoiding unnecessary referral and laboratory evaluation.

Female↗
PubMed1999

Platysma muscle-cervical fascia-sternocleidomastoid muscle (PCS) flap for parotidectomy.

BACKGROUND: Parotidectomy is useful in the treatment of benign and malignant neoplasms of the parotid gland, but often leads to sequelae of facial deformity and Frey's syndrome. This paper presents a retrospective review of parotidectomy results in 21 consecutive patients treated with either traditional techniques or with the rotation and advancement of combined platysma muscle-cervical fascia-sternocleidomastoid flap (PCS). METHODS: The surgical procedures utilized for removal and reconstruction are described. Information on appearance and function was obtained by analysis of hospital and office records and telephone questionnaire for patients with and without the flap. RESULTS: Of the 21 patients eligible for this study, only 9 of 10 patients with the PCS flap and 10 of 11 patients without the flap provided sufficient data for analysis. In the flap group all 9 patients either noted a mild fullness on the operated side or no difference between sides. In the nonflap group, 4 patients felt they had a moderate depression, 2 patients noted a mild depression, and 4 patients noted no difference between sides. Frey's syndrome was classified as mild in 2 patients in the PCS group, whereas in the nonflap group, 4 patients thought it was mild and 1, severe. Complications were rare in either group. CONCLUSION: The PCS flap prevents deformity and contributes to patient satisfaction following parotidectomy. The flap helps to prevent Frey's syndrome and is not associated with an increase in postoperative complications. The flap is recommended following removal of nonrecurrent or low-grade malignant parotid tumors.

Adenoma, Pleomorphic↗
PubMed2000

Frey syndrome: treatment with type A botulinum toxin.

BACKGROUND: Frey syndrome was first described by Baillarger in 1853. Frey provided a detailed analysis and description as "auriculotemporal syndrome" in 1923. According to the literature, even the most recent therapeutic measures described for the treatment of patients with Frey syndrome have little chance of success and a high incidence of side effects. Thus, a type of treatment is desirable that can suppress the symptoms of Frey syndrome and can offer a good success rate, minimum invasiveness, and few side effects. METHODS: The experience of the authors and data from the literature confirmed the efficacy of type A botulinum toxin treatment for patients with Frey syndrome up to a maximum observation period of 3 years. RESULTS: In the current study, seven patients with severe, symptomatic Frey syndrome after parotidectomy were treated successfully with type A botulinum toxin. CONCLUSIONS: The method of local, intracutaneous treatment with type A botulinum toxin for patients with Frey syndrome is effective, virtually side-effect free, and minimally invasive.

Adult↗
PubMed1989

Complications of parotid surgery: the need for selectivity.

The morbidity rate following 112 operations on the parotid gland is reported. Facial nerve palsy (temporary, 38 per cent; permanent, 9 per cent) and Frey's syndrome (11 per cent) were common following superficial parotidectomy. For pleomorphic adenoma and malignant lesions this procedure is justified. Benign conditions, which can be diagnosed preoperatively, should be treated by more limited surgery which has a lower complication rate.

Facial Paralysis↗
PubMedDate not supplied

Parotidectomy: a plastic approach.

Three disadvantages are frequent after parotidectomy: a scar affecting the neck, a deep hollow between the sternocleidomastoid muscle and the mandible (the larger the resection is, the deeper is the hollow), and a sweat secretion. These disadvantages can be prevented or reduced by using four simple procedures: (1) using a facelift incision; (2) using a very simple and original "trick," by displacing outward the posterior belly of the digastric muscle; (3) using a flap with an upper pedicle taken from the sternocleidomastoid muscle; and (4) using a double free graft, taken from the superficial and deep temporal fascias. These two grafts lay down on the net constituted by the preceding flaps. They line the skin, thus blocking the wrong innervation.

Cicatrix↗
PubMed2006

Morbidity of parotid gland surgery: results 1 year post-operative.

Patients operated on for parotid gland tumours were evaluated prospectively to study morbidity after this procedure. Nowadays, major complications such as recurrence of tumour and permanent facial nerve paresis are rare after primary surgery. Therefore, this study especially takes minor complications such as Frey's syndrome and sensory deficits into account. The study documents morbidity in 45 patients who completed a 1 year follow-up. Among those with primary benign tumours, we found no recurrences and no permanent paresis, nor did starch-iodine testing reveal any cases of Frey's syndrome. However, two patients who had previously been operated on multiple times did test positive for Frey's syndrome, as did two others after surgery for malignancy. Furthermore, we found that patients whose posterior branch of the great auricular nerve was sacrificed had a larger area of sensory deficit than those whose nerve was preserved. We conclude that the morbidity of parotid gland surgery can be reduced further by giving minor complications more attention.

Adult↗
PubMed2002

[Botulinum toxin in oromaxillofacial surgery].

BACKGROUND: The muscular system of the jaw and face is characterized by highly differential dynamics due to its strong presence within the motoric region of the cerebral cortex. Abnormal activity of the masticatory or mimic muscular system, whether acquired or congenital, leads to aesthetic and/or functional impairments for the patient. Subsequently, pathological changes of the tissue structure caused by persistent dysfunction can entail chronic pain and progressive aesthetic reduction can induce psychopathological conditions in a patient. OPERATIVE THERAPY: Inherently, surgical techniques for the treatment of muscular imbalances are inadequately differentiated, resulting in the destruction of nerve and muscular structures and are thus irreversible. PHARMACEUTICAL THERAPY: Use of botulinum toxin A can achieve short-term correction of muscular activities with very few side effects if applied in an accurate and controlled manner. This survey presents both established treatments as well as newly developed applications in craniomaxillofacial surgery: (1) the treatment of dysfunctions of the masticatory muscular system, (2) the correction of marked imbalances of the mimic muscular system resulting from surgical treatment, (3) the therapy of salivary gland-associated malfunctions, such as hypersalivation or Frey's syndrome, (4) aesthetic corrections with botulinum toxin A as a single therapy or in combination with collagen injections, (5) EMG-controlled injection of botulinum toxin A as an alternative to surgical treatment of recurrent dislocation of the TMJ, (6) prophylaxis to prevent relapse after mandibular advancement by EMG-controlled paralysis of the geniohyoid muscles.

Botulinum Toxins, Type A↗
PubMed1999

Frey's syndrome after carotid endarterectomy.

Frey's syndrome after carotid endarterectomy (CEA) is due to iatrogenic injury to the auriculotemporal nerve and has not been previously reported. One month after uncomplicated CEA, our patient noted an erythematous flush and copious drainage of clear fluid from the superior portion of his neck wound whenever he ate, or smelled or thought of food. These symptoms lasted for 2 months and eventually resolved without intervention. The cause and treatment of Frey's syndrome is also described.

Aged↗
PubMed2003

Indications for endoscopic thoracic sympathectomy.

The thoracoscopic approach to the sympathetic chain has diminished the trauma of previous open sympathectomy. The minimal trauma has opened the way to manipulate the chain for several conditions. Hand sweat is the most common indication resulting in patient satisfaction 2-13 years after surgery in more than 90%. High satisfaction was also obtained in patients with angina pectoris and a very disabling condition, facial blushing (85 %). Somewhat poorer results were obtained in patients with facial and axillary sweating. In patients with Mb Raynaud-all had recurrences within a year. Since severe side effects, especially compensatory sweating, may occur, the ETS procedure should be reserved only for patients with severe problems where other treatments have failed.

Angina Pectoris↗
PubMedDate not supplied

Diagnosis and management of diabetic autonomic neuropathy.

Autonomic neuropathy affects every system in the body including the eye, cardiovascular, respiratory, and gastrointestinal and neurovascular systems. The diagnosis confers an attenuated life expectancy, but much can be done to alleviate symptoms and to address the underlying disorder.

Autonomic Nervous System Diseases↗
PubMed1975

Experience with 1,360 primary parotid tumors.

Experience with 1,360 primary parotid tumors seen at the Mayo Clinic during two fifteen year periods, 1940 through 1954 and 1955 through 1969, is reviewed. A comparison of histopathologic classification, type of treatment indicated, recurrence rates, and survival in the two periods reveals considerably greater understanding of all factors in the later fifteen year period. The relatively high mortality still encountered among patients with high grade malignant tumors of the parotid glands indicate the nature of the challenge still to be met. Based on the data in this study, it is our opinion that superficial or total conservative parotidectomy is best employed primarily for benign tumors and that the shift to more radical operative procedures should continue in the management of malignant tumors, especially those that are less well differentiated. For experienced surgeons, exceptions might be the small superficially located tumors or the tumors in the lower pole of the gland such as Warthin's tumors. Local excision with removal of a margin of parotid parenchyma might be justifiable in such cases.

Humans↗