Syndrom Freyové po parotidektomii -léčba roztokem chloridu hlinitého

Frey’s Syndrome after Parotidectomy - Treatment with a Aluminum Chloride Solution

Frey’s syndrome (syndrome of the auriculotemporal nerve) which may develop afterparotidectomy is characterized by a triad of symptoms - perspiration, reddening and increasedsensation of heat in the temporal and preauricular region. The syndrome develops due to theaberrant growth of postganglionic, parasympathetic secretomotor fibres into the sheaths of denervated sweat glands.In 1991 to 1997 at the ENT department of the hospital in Frýdek Místek and ENT department of theVítkovice hospital in Ostrava 167 operations of the parotid gland were performed. In 90% conservative superficial parotidectomy (CSPE) was performed, in the remaining patients conservative totalparotidectomy (CTPE) or total radical parotidectomy (TRPE). Seventy-five per cent patients wereoperated on account of a benign tumour, 15% on account of chronic inflammation, 10% on accountof a malignant tumour.In December 1998 the patients were sent questionnaires focused on complaints described by Frey.116 patients replied (70%). Quite free from Frey’s syndrome were 48 patients (42%). The criteria ofFrey’s syndrome were met by 41 patients (35%) which is consistent with data in the literature.Twenty-two patients with Frey’s syndrome were subjected to a baseline examination, incl. Minor’stest. Twelve patients had local treatment with aluminium chloride. Treatment involved dailyapplication of a 15% solution of aluminium chloride to the affected area for a period of eight months.In one instance the complaints receded, in nine instances they improved and in two patients thecondition did not change. According to Minor’s test the areas of pathological secretion were reducedby at least 50% in all patients.Local treatment is the method of therapeutic choice in patients suffering from Frey’s syndrome aftersurgery of the parotid gland.

Key words:
parotidectomy, Frey’s syndrome, auriculotemporal nerve, aluminium chloridesolution, Minor’s test.