FREY SYNDROME

Also known as Auriculotemporal syndrome or Gustatory sweating, it is an unusual phenomenon which arises as a result of damage to the auriculotemporal nerve and subsequent reinnervation of sweat glands by parasympathetic salivary fibers.

Etiology: This syndrome follows some surgical operation (area involving auriculotemporal nerve) , during which the damaged nerve regenerates, parasympathetic nerve supply develops, interacting sweat glands, which then function after salivary, gustatory, or psychic stimulation.

Clinical features: Patient typically exhibits flushing and sweating of the involved face, mainly temporal region, during eating.

Profused sweating can be evoked by parenteral administration of pilocarpine or eliminated by administration of atropine or a prominent block of auriculotemporal nerve.

The syndrome is a possible complication of parotitis, parotid tumor, ramus resection, mandibular resection for correction of prognathism. It has been reported as a complication in as high as 80% of cases following parotidectomy.

Treatment: Intracranial division of auriculotemporal nerve.

Reference: Shafer’s Textbook of Oral Pathology, 9th edition.

PARRY-ROMBERG SYNDROME

INTRODUCTION

Parry-Romberg syndrome is also called as facial hemiatrophy. It is slowly progressive atrophy of the soft tissues of half of the face and also progressive wasting of subcutaneous fat with atrophy of skin,cartilage,bone and muscle.

ETIOLOGY

  • The primary factor being the cerebral disturbances which leads to increased and unregulated activity of the sympathethic nervous system,which inturn leads to localized atrophy.
  • the other factors include:

extraction of teeth

local trauma

infection

genetic factors

disruption of stapedial artery

CLINICAL FEATURES

SEX: females are more affected than males with ratio of 3:2

AGE: occurs generally in the first decade

SITE: Mostly occurs on the left than the right side

CLINICAL PRESENTATION-

  • COUP DE SABRE

It is a painless cleft near the midline of the face or forehead.

Marks the boundary between normal and atrophic tissue.

  • ATROPHY

Bluish hue may appear in the skin overlying atrophic fat.

The affected area extends with atrophy of skin,cartilage,alveolar bone and soft palate on that side of the face.

facial wasting: ipsilateral salivary glands and hemiatrophy of the tongue,unilateral involvement of the ear,larynx,oseophagus,diaphragm,kidney and brain.

  • Pigmentation disorders
  • Facial naevi
  • Contralateral jacksonian epilepsy
  • Contralateral trigeminal neuralgia
  • occular abnormalities

ORAL MANIFESTATIONS

  • Incomplete root formation
  • delayed eruption of teeth
  • difficulty with mastication
  • hemiatrophy of lips and tongue
  • eruption of teeth on the affected side is retarded.

TREATMENT

No specific treatment but cosmetic surgeries are recommended.

cystic hygroma

A cystic hygroma is a fluid-filled sac that results from a blockage in the lymphatic system . It is most commonly located in the neck or head area, but can be located anywhere in the body. It may be discovered in a fetus during a pregnancy ultrasound , or it may be apparent at birth as a soft bulge under the skin.