The Incidence And Severity Of Frey’s Syndrome After Parotidectomy: A Retrospective Study

Yıl 2019, Cilt: 9 Sayı: 2, 74 - 80, 08.08.2019

Mustafa Daloğlu , Kenan Güney

https://doi.org/10.32448/entupdates.568049

Öz

Objective: The aim of this study was to investigate the incidence and severity of Frey’s syndrome (FS) among parotidectomy patients and to assess the impact of parotidectomy sequelae on quality of life (QoL).

Methods: In total, 43 patients (21 males, 22 females) who underwent parotidectomy were included in this study. Iodine-starch test was applied to identify the presence and the severity of FS. The results were evaluated using a previously described grading system. Patients’ perceptions of parotidectomy sequelae were graded to identify their impact on QoL and also if there is an association between the extent of parotidectomy, the time elapsed after surgery and the severity of symptoms.

Results: FS was diagnosed in 18 (41.8%) patients, 10 of which (23.3%) reported having FS symptoms. Of all patients who were diagnosed with FS, 11 (61.2%) patients’ symptoms were classified as mild, whereas 7 (38.8%) were classified as severe. There was no significant correlation between the incidence of FS and the time between surgery and diagnosis, or the extent of parotidectomy. Among all symptoms reported by patients, FS was the sequelae that caused the most discomfort after parotidectomy.

Conclusion: The negative impact of FS on QoL is restricted to cases with severe symptoms, the incidence of which is rare and independent of the extent of surgery. To avoid overtreatment, true incidence of FS remains to be identified in study samples from different centers. By this means, clinicians can make more accurate definitions for indications of preventive procedures as well as treatment approaches.

Anahtar Kelimeler

Frey’s syndrome, parotidectomy, quality of life

Kaynakça

• 1. Erkan SO, Tuhanioglu B, Erkan ZA, Güney Z, Taş ZA. Parotid mass: Toxoplasma lenfadenitis. Entcase 2017;2:325.
• 2. Ford FR, Woodhall B. Phenomena due to misdirection of regenerating fibers of cranial, spinal and automatic nerves. Arch Surg 1938;38:480-96.
• 3. Gardner WJ, McCubbin JW. Auriculotemporal syndrome; gustatory sweating due to misdirection of regenerated nerve fibers. J Am Med Assoc 1956;160:272-7.
• 4. Laccourreye O, Muscatelo L, Naude C et al. Botulinum toxin type A for Frey’s syndrome: a preliminary prospective study. Ann Otol Rhinol Laryngol 1998;107:52-5.
• 5. Rustemeyer J, Eufinger H, Bremerich A. The incidence of Frey’s syndrome. J Craniomaxillofac Surg 2008;36:34-7.
• 6. Minor V. Ein neues Verfahren zu der klinischen Untersuchung der Schweißabsonderung. [Article in German] Deutsche Zeitschrift für Nervenheilkunde 1928;101:302-8.
• 7. Farrell ML, Kalnins IK. Frey’s syndrome following parotid surgery. Aust N Z J Surg 1991;61:295-301.
• 8. Gordon AB, Fiddian RV. Frey’s syndrome after parotid surgery. Am J Surg 1976;132:54-8.
• 9. Linder TE, Huber A, Schmid S. Frey’s syndrome after parotidectomy: a retrospective and prospective analysis. Laryngoscope 1997;107:1496-501.
• 10.Xie S, Wang K, Xu T et al. Efficacy and safety of botulinum toxin type A for treatment of Frey’s syndrome: evidence from 22 published articles. Cancer Med 2015;4:1639-50.
• 11. Luna-Ortiz K, Sansón-RíoFrío JA, Mosqueda-Taylor A. Frey syndrome. A proposal for evaluatin severity. Oral Oncol 2004;40:501-5
• 12. Laage-Hellman JE. Gustatory sweating and flushing after conservative parotidectomy. Acta Otolaryngol. 1957;48:234-52.
• 13. LaccourreyeH,Laccourreye O, Cauchois R et al. Total conservative parotidectomy for primary benign pleomorphic adenoma of the parotid gland: a 25-year experience with 229 patients. Laryngoscope 1994;104:1487-94.
• 14. Lafont M, Whyte A, Whyte J et al. Frey syndrome: factors influencing the time to event. Int J Oral Maxillofac Surg. 2015;44:834-9.
• 15. Tuncel A, Karaman M, Sheidaei S et al. A comparison of incidence of Frey’s syndrome diagnosed based on clinical signs and Minor’s test after parotis surgery. Kulak Burun Bogaz Ihtis Derg 2012;22:200-6.
• 16. Dulguerov N, Makni A, Dulguerov P. The superficial musculoaponeurotic system flap in the prevention of Frey syndrome: A meta-analysis. Laryngoscope. 2016;126:1581-4.
• 17. Sharma R. Prevention of Frey syndrome with superficial temporal fascia interpositioning: a retrospective study. Int J Oral Maxillofac Surg 2014;43:413-7.
• 18. Nofal AA, Mohamed M. Sternocleidomastoid Muscle Flap after Parotidectomy. Int Arch Otorhinolaryngol 2015;19:319-24.
• 19. Xiao M, Shi L, LiuYS. [Effectiveness of acellular dermal matrix and parotid fascia in preventing Frey’s syndrome: meta analysis]. Shanghai Kou Qiang Yi Xue 2014;23:628-33.
• 20. Hayashi A, Mochizuki M, Suda S, et al. Effectiveness of platysma muscle flap in preventing Frey syndrome and depressive deformities after parotidectomy. J Plast Reconstr Aesthet Surg 2016;69:663-72.
• 21. Grosheva M, Horstmann L,Volk GF, et al. Frey’s syndrome after superficial parotidectomy: role of the sternocleidomastoid muscle flap: a prospective nonrandomized controlled trial. Am J Surg 2016;212:740-7.
• 22. Wille-Bischofberger A, Rajan GP, Linder TE et al. Impact of the SMAS on Frey’s syndrome after parotid surgery: a prospective, long-term study. Plast Reconstr Surg 2007;120:1519-23.
• 23. Edward WH. Sternomastoid muscle flap for parotidectomy: the pros and cons. Br J Plast Surg 2002;55:88-9.
• 24. Ahmed OA, Kolhe PS. Prevention of Frey’s syndrome and volume defi-cit after parotidectomy using the superficial temporal artery fascial flap. Br J Plast Surg 1999;52:256-60.
• 25. Cesteleyn L, Helman J, King S, et al. Temporoparietal fascia flaps and superficial musculoaponeurotic system plication in parotid surgery reduces Frey’s syndrome. J Oral Maxillofac Surg 2002;60:1284-97.
• 26. Casani AP, Cerchiai N, Dallan I, et al. Benign tumours affecting the deep lobe of the parotid gland: how to select the optimal surgical approach. Acta Otorhinolaryngol Ital 2015;35:80-7.
• 27. Chulam TC, Noronha Francisco AL, Goncalves Filho J, et al. Warthin’s tumour of the parotid gland: our experience. Acta Otorhinolaryngol Ital 2013;33:393-7.
• 28. Lee CC, Chan RC, ChanJY. Predictors for Frey Syndrome Development After Parotidectomy. Ann Plast Surg 2017;79:39-41.
• 29. Patel N, Har-El G, Rosenfeld R. Quality of life after great auricular nerve sacrifice during parotidectomy. Arch Otolaryngol Head Neck Surg 2001;127:884-8.
• 30. Mehle ME, Kraus DH, Wood BG, et al. Facial nerve morbidity following parotid surgery for benign disease: the Cleveland Clinic Foundation experience. Laryngoscope 1993;103:386-8.