Gustatory sweating (Frey syndrome) is a universal problem after surgery of the parotid region and might be encountered in a large number of pathology cases. Numerous treatment techniques and options have been offered to manage this condition; however, none has met with universal acceptance. This article reviews the history, pathophysiology, incidence, prevention, and management options for gustatory sweating.
Duphenix in 1853 was the first author to report the symptoms of gustatory sweating [1]. Considerable dispute existed in the medical literature during the 19th century regarding liquid production (sweat versus saliva) until Bergounhioux in 1859 demonstrated that the secretion produce was sweat and not saliva [1,2•]. In 1923, Lucie Frey, neurologist at the University of Warsaw, suggested a possible role for the auriculotemporal nerve in the pathophysiology of local skin flushing and sweating at the level of the face during meals after an initial trauma to the parotid region [1,2•]. It was André Thomas in 1927 who suggested an aberrant innervation of the parasympathetic to the sympathic as the possible cause of gustatory sweating [3]. In 1932, Peter Bassoe reported the first case of gustatory sweating after parotidectomy, and during the 20th century parotid surgery appeared to be the main etiologic factor for gustatory sweating [2•]. However, in her landmark study Lucie Frey [1] mentioned that German anatomist Henle had developed gustatory sweating after parotiditis induced by typhoid fewer, and since then, as depicted in Table 1, numerous other causes have been reported as etiologic factors for gustatory sweating.