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First bite syndrome: our experience of laser tympanic plexus ablation
N Amin1, A Pelser1, J Weighill1
1Department of Otorhinolaryngology/Head and Neck Surgery, Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Brighton, UK.
Introduction:
First bite syndrome is a condition characterised by severe facial pain brought on by the first bite of each meal. This can severely affect the patient's ability to eat.
Methods:
We present a 70-year-old woman for whom we performed a laser ablation of the left ear tympanic plexus, as treatment of first bite syndrome. A permeatal approach was used to raise a tympanomeatal flap. The tympanic plexus was identified on the promontory and a 4 mm2 area of the plexus was ablated using CO2 laser. The flap was repositioned and a dressing was placed with topical antibiotics.
Results:
At two-month follow up, there was full resolution of the patient's symptoms.
Discussion:
First bite syndrome carries a high morbidity; treatment options are variable, and often unsuccessful. We describe the first documented case of laser tympanic plexus ablation, with a very effective initial response. This procedure represents a useful therapeutic option for first bite syndrome.
