Background: Frey's syndrome is a socially embarrassing condition commonly involving preauricular area after parotidectomy surgery or trauma to the face. Frey's syndrome over the external ear canal without a prior history of trauma or surgery is extremely rare. To date, there were only two case reports of unilateral spontaneous gustatory sweating in the external ear canal found in the English literature. Case presentation: We report a case of bilateral external ear spontaneous gustatory sweating in a 31-year-old Chinese male. The diagnosis of Frey's syndrome was confirmed by Minor's Starch Iodine test. Conclusions: Comprehensive history and physical examination are mandatory to reach the diagnosis of Frey's syndrome of external ear canal. The treatment option should be tailored individually.
Significance Statement Pulsatile tinnitus with erythematous tympanic membrane mass suggests vascular pathologies such as dural arteriovenous fistula, glomus tympanicum, or aberrant carotid artery. Jugular bulb aneurysmatic diverticulum is rare but should be suspected in a case with the presence of aneurysm in other organs. An imaging study is mandatory to confirm the diagnosis. Patient must avoid digging ear as it can cause profuse bleeding. Treatment option can be open surgery or endovascular treatment.
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