Frey's Syndrome Analysis With Biosensor: A Preliminary Study

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Abstract
Objective: Objective quantification of Frey's syndrome (gustatory sweating), following total parotidectomy. A biosensoring method of enzymatic electrodes enabling the detection of l-lactate on intact skin with the use of a skin extraction device and enzymatic electrodes is presented and analyzed. Design: A criterion standard study. Setting: This prospective trial was undertaken at our research laboratory (University of Paris [France]). Parotidectomy was performed in our department, which is a tertiary care center for parotid gland pathology. Patients: Twenty-eight patients with gustatory sweating following total parotidectomy and nine control patients not operated on were asked to take part in this prospective study. Main Outcome and Measures: Gustatory sweating was assessed in all patients using a clinical scale, the Minor starch iodine test, and the l-lactate biosensoring method. Results: Instrumentation and assay procedure for the l-lactate biosensoring method are detailed. Statistical analysis of data was performed using the Kruskal-Wallis H Test and the Mann-Whitney U Test. Results demonstrate that this method enables objective measurement of the l-lactate on skin without the need for chemical reagents, continuous nondestructive analysis in real time, and physiological dynamic monitoring of the l-lactate rate of production after stimulus. Data achieved strongly suggested that the aberrant regeneration theory is the main clue to Frey's syndrome pathogenesis. Conclusion: This safe, reliable, noninvasive, objective, and highly sensitive method provides an investigative tool for clinicians as well as physiologists involved with patients presenting gustatory sweating following parotid gland surgery. (Arch Otolaryngol Head Neck Surg. 1993;119:940-944)