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Gustatory itching: an unusual complication following superficial parotidectomy

  • R Ricks (a1), R Banga (a1) and M Porter (a1)

Abstract

Objective:

We report the previously undocumented complication of gustatory itching following superficial parotidectomy.

Method:

Case report and review of the English literature concerning Frey's syndrome, complications of superficial parotidectomy and the pathophysiology of itching.

Results:

A 49-year-old woman developed gustatory itching following a superficial parotidectomy. Her symptoms were satisfactorily managed with topical and oral antihistamine preparations. We propose a neurophysiological pathway involving acetylcholine and histamine to explain this phenomenon.

Conclusion:

To our knowledge, this is the first documented case of gustatory itching following superficial parotidectomy. The use of antihistamine preparations appears to effectively manage this symptom, without the need for invasive procedures.

Copyright

Corresponding author

Address for correspondence: Mr Rupert Ricks, Department of ENT, Worcester Royal Hospital, Worcester WR5 1DD, UK. E-mail: rupertricks@doctors.org.uk

Footnotes

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Presented as a poster at the South West ENT Academic Meeting, 19 June 2009, Bath, UK.

Footnotes

References

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1 Nouraei, SA, Ismail, Y, Ferguson, M, McLean, N, Milner, RH, Thompson, PJ et al. Analysis of complications following surgical treatment of benign parotid disease. Aust N Z J Surg 2008;78:134–8
2 O'Neill, J, Condron, C, Curran, A, Walsh, M. Lucja Frey – historical relevance and syndrome review. Surgeon 2008;6:178–81
3 Laskawi, R, Ellies, M, Rodel, R, Schoenebeck, C. Gustatory sweating: clinical implications and etiological aspects. J Oral Maxillofac Surg 1999;57:642–8
4 Schmelz, M. A neural pathway for itch. Nat Neuro 2001;4:910
5 Andrew, D, Craig, A. Spinothalamic lamina I neurones selectively sensitive to histamine: a central neural pathway for itch. Nat Neuro 2001;4:72
6 Jorizzo, JL. Cholinergic urticaria. Arch Dermatol 1987;123:455–7
7 Blandina, P, Fantozzi, R, Mannaioni, P, Massini, E. Characteristics of histamine release evoked by acetylcholine in isolated rat mast cells. J Physiol 1980;301:281–93
8 Fantozzi, R, Masini, E, Blandina, P, Mannaioni, P, Bani-Sacchi, T. Release of histamine by rat mast cells by acetylcholine. Nature 1978;273:473–4
9 Bani-Sacchi, T, Barattini, M, Bianchi, S, Blandina, P, Brunelleschi, S, Fantozzi, R et al. The release of histamine by parasympathetic stimulation in guinea pig auricle and rat ileum. J Physiol 1986;371:2943

Keywords

Gustatory itching: an unusual complication following superficial parotidectomy

  • R Ricks (a1), R Banga (a1) and M Porter (a1)

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