Parotid gland: Frey syndrome: practice question

A Anatomy 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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Anatomy · Parotid gland: Frey syndrome

Sample item

Six months after superficial parotidectomy, a woman notices sweating and flushing of the cheek in front of the ear while eating. What is the underlying mechanism?

ACut ends of the lingual nerve joining the chorda tympaniBAberrant regeneration of parasympathetic fibres of the auriculotemporal nerve to cutaneous sweat glandsCOveractivity of the cervical sympathetic chainDRegeneration of the facial nerve into the great auricular nerve

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

The answer and the reasoning

B. Aberrant regeneration of parasympathetic fibres of the auriculotemporal nerve to cutaneous sweat glands

In Frey syndrome, parasympathetic secretomotor fibres of the auriculotemporal nerve, which normally supply the parotid gland, regrow to the sweat glands and cutaneous vessels of the overlying skin. Eating then stimulates gustatory sweating and flushing. It is treated with topical anticholinergics or botulinum toxin injection.

Option by option

A. Cut ends of the lingual nerve joining the chorda tympani
The lingual nerve and chorda tympani relate to the submandibular and sublingual glands.
B. Aberrant regeneration of parasympathetic fibres of the auriculotemporal nerve to cutaneous sweat glands (correct)
Correct. Misdirected parasympathetic fibres cause gustatory sweating.
C. Overactivity of the cervical sympathetic chain
Sympathetic overactivity would cause sweating unrelated to eating.
D. Regeneration of the facial nerve into the great auricular nerve
The facial nerve is motor and does not supply the sweat glands in this way.

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.

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is B, Aberrant regeneration of parasympathetic fibres of the auriculotemporal nerve to cutaneous sweat glands. In Frey syndrome, parasympathetic secretomotor fibres of the auriculotemporal nerve, which normally supply the parotid gland, regrow to the sweat glands and cutaneous vessels of the overlying skin.

Why is "Cut ends of the lingual nerve joining the chorda tympani" not the answer?

The lingual nerve and chorda tympani relate to the submandibular and sublingual glands.

Why is "Overactivity of the cervical sympathetic chain" not the answer?

Sympathetic overactivity would cause sweating unrelated to eating.

Why is "Regeneration of the facial nerve into the great auricular nerve" not the answer?

The facial nerve is motor and does not supply the sweat glands in this way.

What concept does this question test?

It tests Parotid gland: Frey syndrome in Anatomy. Eating then stimulates gustatory sweating and flushing. It is treated with topical anticholinergics or botulinum toxin injection.

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 Parotid gland: Frey syndrome?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy 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.