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Hyponeophagia: A Measure of Anxiety in the Mouse
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First bite syndrome - An 11-year experience.

Mehmet Özgür Avinçsal1, Yurie Hiroshima2, Hitomi Shinomiya2

  • 1Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Japan; Department of Otorhinolaryngology, Gaziosmanpasa Taksim Training and Research Hospital, Turkey.

Auris, Nasus, Larynx
|August 17, 2016
PubMed
Summary

First bite syndrome (FBS) pain after neck surgery is linked to the sympathetic chain. Sacrificing this chain significantly increases FBS risk, highlighting its role in this chronic pain condition.

Keywords:
Cervical sympathetic trunkDeep lobe of parotid glandExternal carotid arteryFirst bite syndromeParapharyngeal space

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Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Pain Management

Background:

  • First bite syndrome (FBS) is characterized by pain in the parotid region triggered by the first few food bites.
  • It can occur post-operatively following upper cervical region surgeries.

Purpose of the Study:

  • To investigate the etiology of first bite syndrome (FBS).
  • To identify risk factors contributing to this chronic pain condition after neck surgery.

Main Methods:

  • Retrospective review of 53 patients who underwent upper neck surgery between 2002 and 2013.
  • Analysis of FBS development in relation to surgical procedures, including external carotid artery (ECA) ligation and sympathetic chain manipulation.

Main Results:

  • First bite syndrome (FBS) developed in 30% of patients.
  • FBS was more prevalent in patients with parotid deep lobe tumors (50%) compared to other sites (18%).
  • ECA ligation (57%) and sympathetic chain sacrifice (43%) were associated with higher FBS incidence compared to preservation (12.5% and 4%, respectively).

Conclusions:

  • The sympathetic chain plays a significant role in the development of first bite syndrome (FBS).
  • Surgical techniques involving ECA ligation and sympathetic chain sacrifice increase the risk of FBS.