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General Surgery/sweating after parotidectomy

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Question
QUESTION: Sir
Consequent to swelling below my left ear, my parotid gland was removed by way of parotidectomy during 2007.  For an year or so I didn't notice any discrepancies.  But after that while eating, my face becomes reddish and I got sweat in that area, more so when I am eating spicy matter or when eating involves more chewing.  Doctor says that it is common for a patient who has undergone parotidectomy and there is no need to cure this. Kindly advice me for a cure.

ANSWER: Dear Balasubramanian,

The symptoms you describe is known as Frey's Syndrome. It is a benign condition associated with the parotidectomy; there is no cure for it. Changing your dietary habits may help to decrease the excessive sweating; however, it is a small price to pay for such an extensive surgery, and so many other deforming complications that you were fortunate enough not to get.

---------- FOLLOW-UP ----------

QUESTION: Thanks for ur advice.  It is a solace for my disturbed mind.  Please let me know what dietary habits that I have to follow which may decrease the excessive sweating.

Answer
Dear Balasubramanian,

Citric foods, such as lemons, tend to produce the greatest symptoms.
However, after performing a literature review, I came upon several studies that use botulism (Botox), with good results in decreasing the amount of sweat. The following is an abstract from  one of the research studies. I have included a link to the abstract. Good luck, please let me know how you make out.


Botulinum toxin treatment for symptomatic Frey's syndrome.

AuthorsArad-Cohen A, et al. Show all Journal
Otolaryngol Head Neck Surg. 2000 Feb;122(2):237-40.

Affiliation
New York Center for Voice and Swallowing Disorders at St Luke's/Roosevelt Hospital Center, New York, USA.

Abstract
Gustatory sweating, or Frey's syndrome, usually occurs after surgery or trauma to the parotid gland as a result of inappropriate parasympathetic cholinergic innervation of cutaneous sympathetic receptors. Numerous medical and surgical treatments have been proposed to prevent or treat this condition. The results, overall, have been unsatisfactory. Botulinum toxin is a relatively new treatment modality for Frey's syndrome. We review the literature and present our experience with 7 patients successfully treated with intradermal injections of botulinum toxin (Botox). Our technique and dosing are described. In all treated patients gustatory sweating ceased in the area injected with botulinum toxin. In 6 patients, symptoms reappeared, and additional injections were needed up to 4 times, at 6- to 8-month intervals. All patients now have been free of symptoms for a long period of time (mean 12.1 months). We strongly recommend intradermal injections of botulinum toxin as a safe, efficacious treatment for gustatory sweating.

http://www.ncbi.nlm.nih.gov/m/pubmed/10652397/

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Dr. Pamela M. Cipriano, DNP, ACNP-BC

Expertise

GENERAL SURGERY Intestinal obstructions; Perforations; Ostomy; End ileostomy; Hemicolectomy; Take down ileostomy; Ostomy reversals; Diverticulitis; Chrohns Disease; Appendectomy; Cholecystectomy (gallbladder); Ventral hernia repair; Inguinal hernia repair; Umbilical hernia repair; Chest tubes; Pleurex catheters; Lobe-ectomy; Pneumonectomy; Thoracotomy; Pleuradesis; Thyroid surgery; Mastectomy; Lumpectomy LAPAROSCOPIC - LAPAROTOMY - LAPAROSCOPIC ASSISTED

Experience

My name is Dr. Cipriano. I am a Hospitalist on the Medical Staff. I round, admit, discharge, consult and assist with surgeries in the OR. I manage patients in the ICU and Med/Surg floors. I also work in the emergency department. I am certified critical care nurse (CCRN). And ACLS certified. I

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Society of Hospital Medicine American College of Nurse Practitioners Connecticut Advance Practice Registered Nurse Society

Education/Credentials
Maryville University 2014-2016 Doctor of Nursing Practice University of Connecticut 2007-2011 MSN, Acute Care Track Nurse Practitioner. Board Certified September 2011 Central Connecticut State University 2002-2006 BA Psychology St. Mary's Hospital School of Nursing 1991-1993 Diploma Nursing Registered Nurse

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