Management of Frey's Syndrome

James C. Erickson III, MD
JAMA. 1985;254(24):3420-3421. doi:10.1001/jama.1985.03360240032008.
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To the Editor.—  The QUESTIONS AND ANSWERS section regarding Frey's syndrome in The Journal1 brought to light another rarely encountered automatic dysfunction. The profuse unilateral facial sweating response to gustatory stimulation may indeed become milder with passage of time, but the victim of such a distressing situation may perceive it as being endless. Topical applications of 20% aluminum chloride in an alcohol solution as recommended by Dr K. Sato may provide significant relief, but his comments suggest only brief improvement and imply the need for daily treatments.When we administer stellate ganglion blocks, usually for reflex sympathetic dystrophy or causalgia of an upper extremity, we observe the development of a Horner's syndrome, consisting of unilateral dryness of the face, stuffiness of the nostril, and miosis. The beneficial pain relief usually lasts beyond the pharmacologic duration of the local anesthetic and when a series of sympathetic blocks is administered, the


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