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We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

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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.

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Parotid region: Frey syndrome MCQ (B7-ANAT6-26)

Q: What is the answer to this Anatomy question?

The best answer is B, Aberrant regeneration of postganglionic parasympathetic secretomotor fibres of the auriculotemporal nerve to cutaneous sweat glands and vessels. Parasympathetic secretomotor fibres reach the parotid from the glossopharyngeal nerve through the lesser petrosal nerve, the otic ganglion and the auriculotemporal nerve.

Q: What concept does this question test?

It tests Parotid region: Frey syndrome in Anatomy. After surgery, these postganglionic fibres can regrow to the sweat glands and vessels of the overlying skin. Stimuli for salivation, such as eating, then cause gustatory sweating and flushing.

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Anatomy · Parotid region: Frey syndrome

Sample item

Months after superficial parotidectomy, a man sweats and flushes over the preauricular skin while eating. What is the mechanism?

ACross-innervation of the sweat glands by preganglionic fibres of the chorda tympaniBAberrant regeneration of postganglionic parasympathetic secretomotor fibres of the auriculotemporal nerve to cutaneous sweat glands and vesselsCRegeneration of cut greater auricular nerve fibres into the remnant of the glandDRegrowth of sympathetic fibres from the superior cervical ganglion into the parotid gland

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

The answer and the reasoning

B. Aberrant regeneration of postganglionic parasympathetic secretomotor fibres of the auriculotemporal nerve to cutaneous sweat glands and vessels

Parasympathetic secretomotor fibres reach the parotid from the glossopharyngeal nerve through the lesser petrosal nerve, the otic ganglion and the auriculotemporal nerve. After surgery, these postganglionic fibres can regrow to the sweat glands and vessels of the overlying skin. Stimuli for salivation, such as eating, then cause gustatory sweating and flushing.

Option by option

A. Cross-innervation of the sweat glands by preganglionic fibres of the chorda tympani
The chorda tympani supplies submandibular and sublingual glands and does not reach the parotid skin.
B. Aberrant regeneration of postganglionic parasympathetic secretomotor fibres of the auriculotemporal nerve to cutaneous sweat glands and vessels (correct)
Correct. Misdirected parasympathetic fibres in the auriculotemporal nerve cause gustatory sweating.
C. Regeneration of cut greater auricular nerve fibres into the remnant of the gland
The greater auricular nerve is sensory and carries no secretomotor fibres.
D. Regrowth of sympathetic fibres from the superior cervical ganglion into the parotid gland
Sympathetic fibres do not respond to taste stimuli and do not cause eating-related sweating.

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.

Parotid region: Frey syndrome: practice question

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The answer and the reasoning

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