127.Apatient suffers from Frey’s syndrome manifested by perspiration of the skin covering the left parotid gland whenever the patient eats. On inquiry, the patient reveals that he suffered deep injuries on that side of his face and neck in an automobile accident. You explain to him that his syndrome results from abnormal connections between the great auricular nerve and parasympathetic secretomotor fibers, which normally innervate only the parotid gland. This abnormal reinnervation occurred during the healing period after the accident. The parasympathetic secretomotor fibers to the parotid gland are carried by which of the following?
(A) auriculotemporal nerve
(B) buccal branch of the facial nerve
© buccal nerve
(D) greater petrosal nerve
(E) lesser petrosal nerve
Explanation:
(A) The auriculotemporal nerve is a branch of the mandibular division of the trigeminal nerve. It carries postganglionic parasympathetic fibers from the otic ganglion to the parotid gland. The buccal nerve (choice C) is a sensory branch of the mandibular division of the trigeminal nerve. It innervates the gingiva adjacent to the two posterior molar teeth, the mucosa, and skin of the cheek. The buccal branch of the facial nerve (choice B) provides motor innervation to the muscles around the mouth. The greater petrosal nerve (choice D) is a branch of the facial nerve from the geniculate ganglion. It carries preganglionic parasympathetic fibers to the pterygopalatine ganglion. The lesser petrosal nerve (choice E) is a continuation of the tympanic branch of the glossopharyngeal nerve and carries preganglionic parasympathetic fibers to the otic ganglion.