Perspiration and redness of the cheek and ear after eating

 # A 58-year-old woman underwent left superficial parotidectomy for a pleomorphic adenoma 2 years ago. She presents with complaints of occasional perspiration and redness of the left cheek and ear after eating. Which of the following nerves is the most likely source of these complaints? 

A. Great auricular

B. Frontal branch of the facial nerve

C. Auriculotemporal

D. Lingual

The correct answer is C. Auriculotemporal.

The auriculotemporal syndrome is an unusual phenomenon, which arises as a result of damage to the auriculotemporal nerve and subsequent reinnervation of sweat glands by parasympathetic salivary fibers.

The patient typically exhibits flushing and sweating of the involved side of the face, chiefly in the temporal area, during eating. The severity of this sweating may often be increased by tart foods. Of further interest is the fact that profuse sweating may be evoked by the parenteral administration of pilocarpine or eliminated by the administration of atropine or by a procaine block of the auriculotemporal nerve.

Reference: Shafer's Textbook of Oral Pathology, 7th Edition.