Freyâ??s syndrome: A study of the anatomy, physiology and possible role of neurotrophic factors

Frey’s syndrome describes the phenomenon of gustatory sweating and is a cause of significant social embarrassment for sufferers. It has been attributed to aberrant growth of parasympathetic salivatory fibres in the auriculotemporal nerve towards overlying sweat glands. However, the exact mechanism behind this growth is unknown. Frey’s syndrome is a common sequela of parotidectomy and is usually preceded by trauma to the auriculotemporal nerve. In some neonates, however, Frey’s syndrome presents with no history of nerve injury. In these patients, the underlying trigger for Frey’s syndrome is unclear. A review of the recent literature on nerve regeneration after injury and on nervous development in utero was conducted with the aim of developing further insights into the aetiology of both adult onset and paediatric Frey’s syndrome. Neurturin, a neurotrophic factor released by both salivary and sweat glands, was identified as a possible key player in the aetiology of Frey’s syndrome. This factor is released both in utero and after nerve damage, so could connect the two presentations of gustatory sweating. Further research into the role of neurturin could help to elucidate the pathogenic mechanisms underlying the condition and might reveal neurturin to be a potential target for pharmacological intervention.

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