Потение от еды. синдром Фрея ( 2 фото )

A 76-year-old woman with a history of parotidectomy on the left side presented to the otolaryngology clinic with a 2-year history of facial sweating while eating. Seven years earlier, the parotid gland had been removed owing to a pleomorphic adenoma. On physical examination, the patient’s face was symmetric, with equivalent color and moisture of the skin on both sides. On eating pork jerky, her face became progressively more erythematous and sweaty on the left side only (Panel A, 10 seconds after beginning chewing; Panel B, 30 seconds after; Panel C, 50 seconds after; and Panel D, 75 seconds after; ). After 1 minute of chewing, beads of sweat dripped down the patient’s left cheek. A diagnosis of gustatory hyperhidrosis — also known as Frey’s syndrome — after parotid surgery was made. Gustatory hyperhidrosis occurs when there is aberrant reinnervation of the postganglionic parasympathetic fibers of the auriculotemporal nerve, most often after parotid surgery. During eating, this results in activation of cutaneous sweat glands instead of saliva production by the parotid gland. The condition is a common complication of parotidectomy but typically occurs soon after surgery, unlike this case. Treatment with injections of botulinum toxin or with reconstructive surgery was discussed with the patient. However, she opted to live with the symptoms.


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