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First bite syndrome after deep lobe parotidectomy: case report.
1Research Assistant, Third Year Student, Columbia University College of Dental Medicine, New York, NY.
Summary
First bite syndrome (FBS) causes severe facial pain after parapharyngeal space surgery due to nerve damage. This debilitating condition, triggered by eating, may gradually improve over time.
Area of Science:
- Otorhinolaryngology
- Neurosurgery
- Oral and Maxillofacial Surgery
Background:
- First bite syndrome (FBS) is a rare postoperative complication following parapharyngeal space (PPS) surgery.
- PPS surgery is often necessitated by deep lobe parotid gland (PG) neoplasms or cervical schwannomas.
Observation:
- Surgical intervention in the PPS can damage the sympathetic nerve supply to the PG.
- This nerve damage results in intense, debilitating pain in the neck, PG, and auricular regions upon the initial act of eating.
Findings:
- The pain, lasting about 5 seconds, is triggered by salivation from food or even the thought of food.
- Acidic foods can exacerbate the pain, which subsides with continued mastication but may recur with subsequent meals.
Implications:
- Understanding FBS is crucial for surgeons operating in the PPS region.
- Early recognition and management strategies may improve patient outcomes and quality of life.
- Further research is needed to explore long-term management and potential preventative measures for FBS.
