Perioperative care: Frey syndrome after parotidectomy: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Perioperative care: Frey syndrome after parotidectomy

Sample item

After superficial parotidectomy, a patient sweats and flushes over the cheek while eating. What is this and what is its mechanism?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Frey syndrome from aberrant regeneration of auriculotemporal parasympathetic fibres to sweat glands

Frey (gustatory sweating) syndrome follows damage to the auriculotemporal nerve, whose parasympathetic secretomotor fibres regrow to cutaneous sweat glands. Diagnosis is confirmed by the Minor starch-iodine test and treatment with botulinum toxin. The facial nerve is preserved at parotidectomy by identifying the trunk.

Option by option

  • A. First bite syndrome

    First bite syndrome is pain at the first bite after parapharyngeal surgery.

  • B. Horner syndrome

    Horner syndrome has ptosis and miosis.

  • C. Facial nerve palsy

    Facial palsy causes weakness, not sweating.

  • D. Frey syndrome from aberrant regeneration of auriculotemporal parasympathetic fibres to sweat glands (correct)

    Correct. Aberrant parasympathetic regeneration causes it.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Frey syndrome from aberrant regeneration of auriculotemporal parasympathetic fibres to sweat glands. Frey (gustatory sweating) syndrome follows damage to the auriculotemporal nerve, whose parasympathetic secretomotor fibres regrow to cutaneous sweat glands.

Why is "First bite syndrome" not the answer?

First bite syndrome is pain at the first bite after parapharyngeal surgery.

Why is "Horner syndrome" not the answer?

Horner syndrome has ptosis and miosis.

Why is "Facial nerve palsy" not the answer?

Facial palsy causes weakness, not sweating.

What concept does this question test?

It tests Perioperative care: Frey syndrome after parotidectomy in General Surgery. Diagnosis is confirmed by the Minor starch-iodine test and treatment with botulinum toxin. The facial nerve is preserved at parotidectomy by identifying the trunk.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Perioperative care: Frey syndrome after parotidectomy?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.