RESUMO
INTRODUCTION: Frey syndrome is a sequela observed after parotidectomy and the reported incidence varies enormously in the literature. Diagnosis is evaluated by presence of the classic triad of gustatory sweating, heating and flushing while feeding and documented by Minor starch-iodine test. AIM: To evaluate the incidence of this syndrome in patients submitted to partial parotidectomy at Centro Otorrinolaringológico de Limeira, from 1994 to 2004, including presence of signs and symptoms and the surgical technique. MATERIAL AND METHOD: Fourteen patients undergoing partial parotidectomy with sternocleidomastoid muscle flap answered a questionnaire and were classified as positive or negative by Minor starch-iodine test in a clinical retrospective study. RESULTS: 21% of the patients presented symptoms and positive iodine test. CONCLUSION: Only the patients presenting clinical symptoms had a positive test and the adopted surgical technique was efficient due to low incidence of the syndrome.
Assuntos
Glândula Parótida/cirurgia , Complicações Pós-Operatórias/etiologia , Sudorese Gustativa/etiologia , Humanos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Prevalência , Estudos Retrospectivos , Retalhos Cirúrgicos , Inquéritos e Questionários , Sudorese Gustativa/diagnóstico , Sudorese Gustativa/epidemiologiaRESUMO
INTRODUÇÃO: síndrome de Frey é uma seqüela observada após parotidectomia com incidência que varia muito na literatura. O diagnóstico é avaliado pela presença da tríade clássica - sudorese, calor e hiperemia na face, durante a alimentação - e documentado pelo teste com amido e iodo de Minor. OBJETIVO: Avaliar a incidência desta síndrome nos pacientes submetidos à parotidectomia parcial, no Centro de Otorrinolaringologia de Limeira, no período de 1994-2004 e correlacioná-la com os achados clínicos e com a técnica cirúrgica utilizada. MATERIAL E MÉTODO: Quatorze pacientes foram submetidos à parotidectomia parcial com rotação de retalho pediculado do músculo esternocleidomastóideo e responderam a questionário e a seguir foi realizado o teste do iodo, classificando-se os pacientes em positivos e negativos para o teste em um estudo clínico retrospectivo. RESULTADO: Nesta casuística, observamos que 21 por cento dos pacientes após parotidectomia parcial apresentaram positividade para o teste, sendo os mesmos pacientes que apresentaram queixas clínicas ao responderem o questionário. CONCLUSÃO: Somente os pacientes que apresentaram sintomatologia clínica tiveram positividade no teste do iodo, e a técnica cirúrgica empregada foi eficiente no tratamento da patologia da glândula, pois apresentou baixa incidência de acordo com a literatura pesquisada.
INTRODUCTION: Frey syndrome is a sequela observed after parotidectomy and the reported incidence varies enormously in the literature. Diagnosis is evaluated by presence of the classic triad of gustatory sweating, heating and flushing while feeding and documented by Minor starch-iodine test. AIM: to evaluate the incidence of this syndrome in patients submitted to partial parotidectomy at Centro Otorrinolaringológico de Limeira, from 1994 to 2004, including presence of signs and symptoms and the surgical technique. MATERIAL AND METHOD: fourteen patients undergoing partial parotidectomy with sternocleidomastoid muscle flap answered a questionnaire and were classified as positive or negative by Minor starch-iodine test in a clinical retrospective study. RESULTS: 21 percent of the patients presented symptoms and positive iodine test. CONCLUSION: only the patients presenting clinical symptoms had a positive test and the adopted surgical technique was efficient due to low incidence of the syndrome.
Assuntos
Humanos , Complicações Pós-Operatórias/etiologia , Glândula Parótida/cirurgia , Sudorese Gustativa/etiologia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Prevalência , Inquéritos e Questionários , Estudos Retrospectivos , Retalhos Cirúrgicos , Sudorese Gustativa/diagnóstico , Sudorese Gustativa/epidemiologiaRESUMO
We aimed to establish the incidence of Frey's syndrome in patients that have been submitted to partial and total parotidectomy at a cancer-treating hospital in Mexico City and to propose a grading system to determine its severity. The incidence of Frey's syndrome in 77 patients (25 male and 52 female) under oncological follow-up due to parotid tumors was subjectively evaluated through clinical findings and objectively diagnosed through Minor's test. The positive hyperhydrotic areas were recorded and measured on transparent acetates. Numeric values were assigned according to clinical perception of symptomatology by the patients (0 for no perception and 1 for clinical recognition), extent of the affected area (1 if less than 2 cm; 2 if between 2.1 and 4 cm, and 3 if more than 4 cm), intensity and smell of sweat (3 if it was excessive or of unpleasant odor). Results were expressed as mild (if less than 4 points) or severe grades (if 4 or more points). Frey syndrome was objectively diagnosed in 28 patients (36%), although only 17 (22%) recognized to have clinical manifestations of this condition. There were 22 women (79%) and six men (21%). Of these, seventeen (61%) had been subjected to partial and eleven (39%) to total parotidectomy. Adjuvant radiotherapy had been employed in nine cases (32%). The cutaneous affected area in the whole group ranged from 0.7 to 29.8 cm(2) (mean 8.9 cm(2)), with a mean affected surface of 8.7+/-10.8 cm(2) for women and 9.0+/-8.8 cm(2) for men ( p > 0.05). Twelve cases were classified as mild and sixteen as severe. No significant differences were found between patients treated with partial vs. total parotidectomy or between patients treated with or without adjuvant radiotherapy. The incidence of Frey's syndrome in Mexican patients seems to be similar to those reported in other countries; however, the extent of hyperhydrosis is lower when compared to some European studies. Our proposal for evaluating this condition may be a helpful tool in assessing the incidence and severity among the diverse populations and it may be a useful tool to define more precisely the indications for treatment and to evaluate the available therapeutic methods according to the severity of the condition.