APPLICATION OF MEDICAL THERMOGRAPHY TO THE DIAGNOSIS OF FREYS-SYNDROME

Background: In Prey's syndrome, the secretory parasympathetic fibers o f the parotid gland are thought to communicate with the sympathetic ne rve fibers of sweat glands and blood vessels of the skin following par otidectomy. Miscommunication results in subjective gustatory sweating and facial flushing, which appear early with postoperative mastication . In this study, we compared the efficacy of medical thermography to t he Minor's starch-iodine test to determine the presence of gustatory s weating in Prey's syndrome. Methods: Patients were considered to have Prey's syndrome if signs of gustatory sweating and localized skin flus hing of the parotid region were present. In four patients who had unde rgone unilateral parotidectomy, gustatory sweating and facial flushing were present after gustatory stimulation, and the presence of Prey's syndrome was confirmed with Minor's starch test in all patients. Infra red thermography was then performed, and the same area measured. The c ontralateral side served as an internal control for each patient. Resu lts: Before gustatory stimulation, the isothermal pattern of the disea sed side and the nonoperative side was similar. Stress thermography us ing a sialogogue (lemon, 3 mt) showed a cold spot at the operative sit e in all four patients with Prey's syndrome. The contralateral nonoper ative side showed normal skin temperature distribution in all patients . Minor's test was positive in all patients. Conclusions: Thermography is a noninvasive, facile test that provides a qualitative visual anal ysis of the cutaneous capillary response in Prey's syndrome following parotid surgery. (C) 1997 John Wiley & Sons, Inc.