Gustatory Sweating and Flushing: Aetiological Implications of Latent Period and Mode of Development after Parotidectomy

Abstract

The time of onset and mode of development of gustatory sweating and flushing in the face (G.S.F.) after parotidectomy have been studied. Serial provocation tests on 57 adults disclosed that the initial onset of G.S.F. occurred not less than 5 weeks after the operation. The Repeated estimations of the area with gustatory sweating in 44 of these subjects revealed that the area grew larger in 41 of them. The first finding shows that misdirected regeneration to the skin of severed salivary nerve fibres could have taken place during the latent period and thus cannot be ruled out as a cause of G.S.F. The second finding shows that G.S.F. involves an increasing number of end organs and develops progressively rather than suddenly as would have been the case if it were caused by so-called denervation hypersensitivity. These two observations thus bear out the theory that G.S.F. after parotidectomy is caused by misdirected regeneration to the skin of severed salivary nerve fibres.