Guidelines for Complications of Cancer Treatment Vol VIII Part B

flushing) and localized sweating (gustatory sweating) duringmeals.Prevention (LOE-3)Various methods described in literature are1. Minimize the parotid wound bed while adequatelyremoving the pathology.2. Thick skin flaps.3. Rotation of the superficial musculoaponeurotic (SMAS)layer to ameliorate the parotidectomy defect. It involvesplacating the SMAS layer to the sternocleidomastoidmuscle and perichondrium of the external ear.4. Interposition of barriers to prevent aberrant reinnervationof parasympathetic fibers.The temporoparietal flap is a reliable and versatileflap and has close proximity to the parotid bed.Implantation of materials like lyophilized dura,polygalactin, expandable polytetrafluroethyleneand human dermal matrix has been used. Thesematerials however increase the chance of a parotidfistula. Less resorbable implants are better barriersbut have a higher incidence of fistulas.Sternocleidomastoid muscle flap to fill the defect– Doubtful value and masks recurrences.Treatment: (LOE-3)DetectionTesting for Frey’s syndrome has in general been limited to theevaluation of sweating. The most frequently used method ofsweat secretion assessment for gustatory sweating wasoriginally described by Victor Minor, a Russian neurologist.233