Prevention of “eating and sweating syndrome” after parotid surgery

In conventional parotid tumor surgery, the superficial lobe of the parotid gland needs to be removed while protecting the branches of the facial nerve and the tumor is removed. In this case, if care is not taken, the residual parotid tissue will be stretched and sutured directly to the facial subcutaneous tissue, which often leads to postoperative “eating and sweating syndrome” (Frey’s syndrome), i.e., the patient’s face will become flushed and sweaty whenever he/she eats, and the patient cannot control it. This affects the patient’s quality of life after surgery, especially in important situations. The reason for this is that the parasympathetic peripheral nerves of the parotid gland form an innervation relationship with the sweat gland tissue under the skin during surgery, and when eating, they innervate the sweat gland tissue under the skin through these parasympathetic nerves, causing sweating, which has a negative impact on the patient in some special occasions. And in some patients, sometimes parotid tumor involves deeper area, even need to remove deep lobe tissue of parotid gland or total parotidectomy, which will bring a large facial defect and affect the beauty, especially for some young patients, which will bring some psychological burden. By preserving the parotid fascia, the postoperative parasympathetic nerve endings that govern the secretion of the parotid glands can be prevented from intermingling with the skin sweat glands, thus avoiding the postoperative “eating and sweating syndrome”. At the same time, by backfilling part of the sternocleidomastoid muscle to the parotid gland defect area, the sunken area was avoided and the symmetry of both sides of the face was ensured, which greatly improved the patient’s postoperative quality of life. Through close follow-up observation, the incidence of Frey’s syndrome in our patients after surgery was almost zero, and all patients expressed satisfaction with the postoperative facial appearance and the symmetry of both sides of the face.