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Final Program

Other / General Medicine

1204 - Emergence of Frey's Syndrome Symptoms Following Gastric Sleeve Surgery: A Case Report

Friday, February 20, 2026
5:00 PM - 6:30 PM AST

    Co-Author(s)

  • MK

    Muhammad Khattak, n/a

    Medical Student
    Lake Erie College of Osteopathic Medicine
    Erie, Pennsylvania, United States

    • Presenting Author(s)

  • PB

    Pranav Bollavaram, MD

    Cancer Rehabilitation Fellow
    Memorial Sloan Kettering Cancer Center
    New York, New York, United States

    • Co-Author(s)

  • JP

    Jesuel Padro Guzman, MD

    Cancer Rehabilitation Physiatrist
    Memorial Sloan Kettering Cancer Center
    New York, New York, United States

    • Submitter(s)

  • PB

    Pranav Bollavaram, MD

    Memorial Sloan Kettering Cancer Center
    New York, New York, United States

Case Diagnosis: Frey's syndrome following parotidectomy, with worsening symptoms after gastric sleeve.

Case Description: This case describes a 45-year-old gentleman with a history of obesity and left-sided mucoepidermoid tumor of the parotid gland. He underwent a left-sided superficial parotidectomy and, two years later, he underwent gastric sleeve surgery. Following the gastric sleeve surgery, he noticed gustatory sweating localized to his left cheek and jaw region. It was not associated with any other neurological changes, and he maintained normal speaking and swallowing function. He was evaluated by otolaryngology and diagnosed with Frey’s Syndrome. Collateral history from his wife revealed that since his gastric surgery, he had begun taking a significantly longer time to chew and finish meals. He was referred to rehabilitation for consideration of botulinum toxin injection.

Discussions:

Frey’s Syndrome is a phenomenon that occurs after an insult to parasympathetic and sympathetic nerve fibers within the auriculotemporal nerve, with improper reinnervation patterns leading to inappropriate activation of sweat glands with parasympathetic stimulation. Classically it occurs after a parotidectomy, as is in this case, though other etiologies are documented. Symptoms emerge at variable times post-surgery, ranging from within a year to several decades. This case is unique in that the onset of symptoms coincides with the increased time of chewing following gastric surgery. This relationship is a point that should be considered for rehabilitation patients who have facial surgery or other trauma and can drive patient conversations.

Conclusions:

Frey’s Syndrome can be uncomfortable and functionally limiting for patients. Understanding the symptom onset and risk factors in symptom emergence is important for rehabilitation medicine providers for treatment decisions and patient education.