First Bite Syndrome in Transoral Surgery for Oropharyngeal Cancer

Area of Science:

• Otolaryngology
• Surgical Oncology
• Head and Neck Surgery

Background:

• First bite syndrome (FBS) is a rare complication following transoral surgery (TOS) for oropharyngeal squamous cell carcinoma (OPSCC).
• Risk factors for FBS after TOS are not well-defined, necessitating further investigation to improve patient outcomes.

Purpose of the Study:

• To identify risk factors associated with the development of FBS in patients undergoing TOS for OPSCC.
• To elucidate the relationship between surgical techniques and the incidence of FBS.

Main Methods:

• Retrospective chart review of patients who underwent TOS for OPSCC at a tertiary care center.
• Analysis of demographic data, comorbidities, tumor characteristics, surgical details, and adjuvant treatment.
• Statistical analysis including Fisher's Exact test, Kruskal-Wallis rank sum test, and multivariable logistic regression to identify significant risk factors.

Main Results:

• Seven out of 89 eligible patients (7.9%) developed FBS.
• Palatine tumor location, resection of styloglossus/stylopharyngeus muscles, and parapharyngeal fat manipulation were associated with FBS.
• Parapharyngeal fat manipulation remained a significant independent risk factor after adjusting for tumor location; 86% of affected patients experienced resolution.

Conclusions:

• Manipulation of the parapharyngeal space is an independent risk factor for developing FBS after TOS for OPSCC.
• Further research is warranted to confirm these findings and explore preventative strategies.