Delayed Frey Syndrome After Closed Treatment of Condylar Fracture

Abstract

Frey syndrome is also known as auriculotemporal syndrome and gustatory sweating. It is characterized by the occurrence of hyperesthesia, flushing, and warmth or sweating over the distribution of the auriculotemporal nerve and/or greater auricular nerve while eating foods that produce a strong salivary stimulus. It is commonly seen as a complication of parotidectomy and open surgery of temporomandibular joint. It can also be caused by other forms of trauma, including blunt trauma, but rarely does it occur without trauma. The relation between fracture displacement of the condyle and Frey syndrome adds further support to the view of the intimate anatomic relationship of the auriculotemporal nerve with the capsule of the temporomandibular joint. However, despite the proximity of these structures and the high incidence of condylar fracture ( 25%-36% of mandibular fractures), Frey syndrome is rare after this type of fracture. Symptoms are sometimes delayed and can be very slight; often neither the patient nor the surgeon realizes their presence. The symptoms usually appear 5 weeks to 1 year after nerve damage. In this clinical report, we presented the delayed occurrence of Frey syndrome in a patient in 6 years after closed reduction of condylar fracture. One prospective study and 11 case reports describing the development of Frey syndrome after closed treatment of mandibular condyle fractures were found in the last 4 decades. Our clinical report participates to literature as a 12th case report.