Between 1980 and 1990, 35 patients underwent conservative parotidectomy combining a
rhytidectomy incision and a superficial musculoaponeurotic system preservation technique to reduce the postoperative incidence of
Frey's syndrome. All patients were evaluated by questionnaire for subjective symptoms of
gustatory sweating and
flushing as well as satisfaction with the aesthetic appearance of their cheek. Six percent of patients (2 of 35) complained of symptoms of
Frey's syndrome. Ninety-four percent of patients (33 of 35) noticed minimal or no contour
deformity of the surgical area. Twenty patients underwent Minor's
starch iodine testing to identify objective evidence of aberrant nerve regeneration at the postoperative site. Fifteen percent of these patients (3 of 20) demonstrated a positive
starch iodine test; however, one of these three patients was unaware of symptoms of
Frey's syndrome. Symptoms of
gustatory sweating are a reliable
indicator of aberrant nerve regeneration. Conservative parotidectomy with superficial musculoaponeurotic system preservation for benign
parotid disease produces a low incidence of
Frey's syndrome and satisfactory cosmetic results.