Key aspects in the reduction of probability to establish
symptomatic Frey’s syndrome
Intraoperatively, the prevention of synkinesis seems to be key, not
affecting the superficial sweat glands and is done by increased skin
flap thickness or using local fascia or muscle flaps. Therefore used
flaps can be a transposition fascia flap, a temporoparietal fascia flap
[11], a sternocleidomastoid muscle flap, and a superficial
musculoaponeurotic system flap. [3, 12]
Further, the use of acellular dermal matrix (ADM)[13], the injection
of polyglycolic acid[14], elevation of a vascularized fat
flap[15] or free fat grafts (AFG) with abdominal free fat [8]can
prevent symptomatic Frey’s syndrome.[3]