Fat injections for the management of post-parotidectomy Frey syndrome : a technical note

Purpose: Frey syndrome (profuse sweating and cutaneous flushing in the area innervated by the auriculotemporal nerve) is a frequent and unpleasant complication of parotidectomy. Fat injections may be useful in preventing the abnormal nerve neo-anastomoses sprouting to the sweat glands that are responsible for gustatory sweating, but have never been used before. Material and methods: We describe the use of fat injections into the parotid gland of four patients with post-parotidectomy Frey syndrome. Results: All of the patients experienced a clinical and subjective improvement, although slight sweating persisted. There were no untoward effects during the procedure and, in particular, no facial nerve impairment. Conclusion: On the basis of our experience minimally invasive fat injections can be considered in the case of post-parotidectomy Frey syndrome, but patients should be informed that subsequent procedures may be needed to achieve a definitive result.