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

PurposeFrey 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 methodsWe describe the use of fat injections into the parotid gland of four patients with post-parotidectomy Frey syndrome.ResultsAll 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.ConclusionOn 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.