First Bite Syndrome: A Rare Post-Surgical Complication Following a Carotid Body Tumor Excision
Noura M AlOtaibi1,2, Ali N Alanzan3, Abdulaziz K Aloshaywi3
1Oral and Maxillofacial Surgery, University of Glasgow, Glasgow, GBR.
Cureus
|January 6, 2025
Summary
First bite syndrome (FBS) causes severe parotid pain with initial food intake. This rare surgical complication, often linked to sympathetic nerve injury after head and neck procedures like carotid body tumor excision, requires further awareness.
Area of Science:
- Otolaryngology
- Neurosurgery
- Surgical Complications
Background:
- First bite syndrome (FBS) is a rare complication following head and neck surgeries.
- It presents as sharp, intense parotid pain triggered by the first bite of food.
- Potential causes include injury to the cervical sympathetic trunk during surgery.
Observation:
- A 36-year-old male experienced FBS after carotid body tumor (CBT) excision.
- Pain occurred specifically with the first bite, gradually subsiding with continued chewing.
- The affected area was the ipsilateral parotid gland region.
Findings:
- Sympathetic denervation of the parotid gland may lead to hypersensitivity to parasympathetic stimulation, causing FBS.
- Injury or amputation of the cervical sympathetic trunk is a suspected mechanism.
- The pathophysiology involves altered autonomic innervation of the salivary glands.
Implications:
- This case highlights FBS as a potential complication of carotid body tumor surgery.
- Increased awareness among maxillofacial surgeons is crucial for diagnosis and management.
- Further research is needed to establish optimal treatment strategies for FBS.
Related Concept Videos
01:28Esophageal Perforation-II: Clinical Manifestations and Management
1.1K
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
1.1K
01:24Healing II: Complications
37
Complications during healing arise when tissue repair is altered by local or systemic factors. These changes involve abnormal collagen deposition, altered biomechanics, and reduced vascular supply, impairing restoration of normal structure and function.Loss of FunctionScar tissue differs significantly from the original tissue it replaces. In the skin, fibrosis lacks adnexal structures such as hair follicles, sebaceous glands, and sweat glands. Their absence reduces tactile sensitivity, impairs...
37