Hyperhidrosis, gustatory R61.0

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Gustatory hyperhidrosis; Gustatory sweating; gustatory sweating and flushing; hyperhidrosis gustatory; Sweating gustatory

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Duphenix, 1757; Frey, 1923

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Excessive sweating in certain skin areas of the head and neck area, especially due to gustatory stimuli when chewing, biting, tasting. Frequently occurring after surgical interventions on the parotid gland (lateral, conservative or radical parotidectomy), sweating areas (after parotidectomy in almost 100% of cases) are most frequently found in the areas of the auriculotemporal nerve ( auriculotemporal syndrome) or the auricular nerve. In addition to the well-known gustatory sweating, the syndrome is also characterized by other symptoms such as gustatory flushing, tingling, a feeling of swelling and even burning skin.

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pathogenesis has not yet been fully clarified. Probably, regenerating parasympathetic (secretory) fibres, which have been damaged during surgery, come into contact with the normally sympathetically innervated skin sweat glands. The neurotransmitter acetylcholine, which is common to both types of nerve fibres, can trigger hyperhidrosis in its target organ, the eccrine sweat glands, via pathologically controlled innervation.

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Normally not required. In case of massive impairment, intradermal application of botulinum toxin A into the previously marked hyperhidrotic area. For details see auriculotemporal syndrome.

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  1. Connolly M et al (2003) Management of primary hyperhidrosis: a summary of the different treatment modalities. At J Clin Dermatol 4: 681-697
  2. Duphenix M (1757) Observations sur les fistules du canal salivaire de Stenson. I. Sur une playe compliquee a la joue ou le canal salivaire fut dechire. Mem Acad R Chir 3: 431-439
  3. Eckardt A et al (2003) Treatment of gustatory sweating (Frey's syndrome) with botulinum toxin A. Head Neck 25: 624-628
  4. Frey L (1923) Le syndrome du nerf auriculo-temporal. Rev Neurol (Paris) 40: 97-104
  5. Itschert G (2004) Treatment of a Frey syndrome with botulinum toxin A. Derm 10: 16-18


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Last updated on: 29.10.2020