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First Bite Syndrome Following Rhytidectomy: A Case Report.
Anne E Gunter1, Charles M Llewellyn1, Paloma B Perez1
1Otolaryngology-Head and Neck Surgery, Madigan Army Medical Center, Tacoma, WA, USA.
The Annals of Otology, Rhinology, and Laryngology
|June 23, 2020
Summary
First bite syndrome (FBS) can occur after face-lift surgery due to parotid gland dissection. This condition, characterized by initial chewing pain, typically resolves with observation within a year.
Area of Science:
- Plastic Surgery
- Head and Neck Surgery
- Facial Rejuvenation Procedures
Background:
- First bite syndrome (FBS) is a rare complication typically associated with parotid gland surgery.
- It presents as sharp pain in the parotid region triggered by the first bite of a meal, subsiding with subsequent bites.
- While rhytidectomy (face-lift) involves dissection near the parotid gland, it's not commonly linked to FBS.
Observation:
- A case study details a 53-year-old female who developed FBS three weeks after a deep plane face-lift.
- She experienced pain at the start of mastication that improved during meals.
- Symptoms gradually resolved over six months without intervention.
Findings:
- The study suggests that inadvertent injury to the parotid gland's parenchyma during rhytidectomy can damage sympathetic nerve fibers.
- This damage may lead to the development of First Bite Syndrome post-operatively.
- The complex innervation of the parotid gland, involving multiple nerves, underscores the potential for such complications.
Implications:
- First bite syndrome should be considered a potential, albeit uncommon, complication of rhytidectomy.
- Expectant management is the primary treatment approach for FBS following facial surgery.
- Complete symptom resolution is typically observed within six months to one year.
