Following a parotid surgery, the patient developed sweating over the side of his face and over the cheek while eating. This is due to abnormal connections that develop between parasympathetic secretomotor fibres in the auriculotemporal nerve with which of the other nerves?
**Core Concept**
The development of abnormal connections between parasympathetic secretomotor fibers in the auriculotemporal nerve is known as Frey's syndrome or gustatory sweating. This condition occurs due to the aberrant regeneration of parasympathetic nerve fibers in the auriculotemporal nerve, which then form synapses with sympathetic cholinergic fibers in the zygomatic branch of the facial nerve or the buccal branch of the mandibular division of the trigeminal nerve.
**Why the Correct Answer is Right**
In Frey's syndrome, the aberrant parasympathetic secretomotor fibers from the auriculotemporal nerve synapse with the sympathetic cholinergic fibers in the zygomatic branch of the facial nerve or the buccal branch of the mandibular division of the trigeminal nerve. This leads to the release of acetylcholine, causing the sweat glands to contract and sweat to be produced in response to the sight, smell, or taste of food. This condition is a classic example of aberrant regeneration of nerve fibers after nerve injury.
**Why Each Wrong Option is Incorrect**
**Option A:** The glossopharyngeal nerve is not directly involved in Frey's syndrome. It is the nerve responsible for transmitting sensory information from the tongue and palate, but it is not the nerve that forms abnormal connections with the auriculotemporal nerve.
**Option B:** The vagus nerve is not involved in Frey's syndrome. It is responsible for transmitting parasympathetic information to various organs in the thorax and abdomen, but it is not the nerve that forms abnormal connections with the auriculotemporal nerve.
**Option C:** The trigeminal nerve is involved in Frey's syndrome, but not as the primary nerve that forms abnormal connections with the auriculotemporal nerve. The buccal branch of the mandibular division of the trigeminal nerve is one of the nerves that may receive aberrant parasympathetic fibers from the auriculotemporal nerve.
**Clinical Pearl / High-Yield Fact**
Frey's syndrome is a classic example of aberrant regeneration of nerve fibers after nerve injury. It is essential to be aware of this condition to accurately diagnose and manage patients who have undergone parotid surgery.
**Correct Answer:** C. The buccal branch of the mandibular division of the trigeminal nerve.