A new concept in the treatment of Frey's syndrome: the use of interpositional dermal grafts. An experimental study in the dog.

Frey's syndrome or gustatory sweating is a common complication of parotid gland injury or surgery. Forty to 60 percent of the patients undergoing parotidectomy will develop manifestations of this syndrome but only 10-15 percent of these require treatment. To date tympanic neurectomy is the most efficacious method of treating the problem but relief is not obtained in all cases. Based on an experimental study in the dog, a new approach to the prevention of Frey's syndrome is presented. Since Frey's syndrome is due to the aberrent regeneration of parasympathetic nerve fibers of the parotid gland into the severed sympathetic nerve endings in skin overlying the gland, it is proposed that the insertion of a dermal graft barrier between the resected parotid gland and the skin will prevent Frey's syndrome. Histological sections of dermal grafts, buried for three to six months tend to confirm that this idea has some merit.