Evidence suggests that grafts are effective in preventing Freys syndrome after parotidectomy


Freys syndrome (gustatory sweating) is frequently noted as complication of surgery to the parotid gland. It is characterized by sweating while eating and facial flushing.  It was first reported by Lucie Frey in 1923.  The aim of this review was to determine the effect and safety of different types of grafts for the prevention of Frey syndrome after parotidectomy.

The Medline, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, World Health Organization International Clinical Trials Registry Platform and the China National Knowledge Infrastructure databases were searched together with relevant journals and the reference lists of the included studies. Randomised controlled trials (RCT) studying the effect and safety of different types of grafts for preventing Frey syndrome after parotidectomy were included. Studies were assessed using the Cochrane Collaboration’s risk of bias tool.

  • 14 trials (1,098 participants) were included. All the trials had an unclear risk of bias.
  •  Nine studies were involved in the comparison of the acellular dermis matrix graft (ADMG) versus no graft with meta-analysis showing that the use ADMG can reduce by 82% the risk of Freys syndrome compared with the no-graft group using an objective assessment (relative risk [RR] 0.18, 95% confidence interval [CI] 0.12 to 0.26; P < .00001.
  • Six studies with an objective assessment of Freys syndrome compared the muscle flap graft versus no graft, with meta-analysis showing that the use of muscle flaps could reduce 81% of the risk of Freys syndrome compared with no graft (RR 0.19, 95% CI 0.13 to 0.27; P<.00001).
  • Only 1 study compared the acellular dermis matrix graft with the muscle flaps flap with the results showing no statistical significance between the 2 grafts.

The authors concluded

The present clinical evidence suggests that grafts are effective in preventing Frey syndrome after parotidectomy. More randomized clinical trials are needed to confirm our conclusions and prove the safety of the grafts.


Li C, Yang X, Pan J, Shi Z, Li L. Graft for Prevention of Frey Syndrome After Parotidectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Oral Maxillofac Surg. 2012 Aug 9. [Epub ahead of print] PubMed PMID: 22884117.

Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+
Mark as read
Create a personal elf note about this blog
Profile photo of Derek Richards

Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. He is a former editor of the Evidence-Based Dentistry Journal, the chief blogger for the Dental Elf website and a past president of the British Association for the Study of Community Dentistry. He has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Retired from the NHS he is currently a part-time senior lecturer at Dundee Dental School.

More posts - Website

Follow me here –