Frey's syndrome following parotidectomy: prevention using a rotation sternocleidomastoid muscle flap

The benefit of using a sternocleidomastoid flap following parotidectomy to reduce the incidence of symptomatic gustatory sweating (Frey's syndrome) wa s reviewed. A retrospective study was undertaken to review subjective and o bjective symptoms of Frey's syndrome in two groups of patients, one of whom had undergone superficial parotidectomy with a sternocleidomastoid flap ro tated at the time of surgery and a second group of patients who had undergo ne a standard superficial parotidectomy. A total of 22 patients, randomly s ampled and willing to attend, were evaluated postoperatively, at a median t ime from surgery of 42 months (range 23-82 months) in the non-flap group an d 44 months (range 14-66 months) in the flap group, by Minor's starch iodin e test. In the 11 patients who had a sternocleidomastoid flap rotated, two had evidence of gustatory sweating. Of the 11 that had not undergone sterno cleidomastoid flap rotation, nine patients showed evidence of gustatory swe ating (P < 0.05, chi(2) test). There were two patients in total who had cli nical symptoms of Frey's syndrome and both of these had not undergone flap rotation at the time of parotidectomy.