First bite syndrome: clinical study of six cases and review of the literature

Abstract

Objective:The aim of this study is to explore the etiology, diagnosis and treatment of first bite syndrome（FBS）. Method:Clinical data of six patients with FBS were analyzed retrospectively. There were 4 cases of parapharyngeal space tumor resection complicated with FBS, 1 case of parotidectomy of deep lobe parotid gland tumor complicated with FBS, and 1 case of no definite cause. Analgesic treatments such as ibuprofen and tramadol capsules were given, in combination with carbamazepine （200 mg, 3 times a day） for four weeks. Result:The severity of symptoms decreased in five cases, 2-16 months after treatment. While another one had no amelioration during 10 months' follow-up. Conclusion:FBS is one of the possible complications of surgery of the upper cervical region, especially parotid deep lobe tumor resection, which should be distinguished from the usual postoperative pain. The cause of the disease may be related to intraoperative injury to the sympathetic plexus of the parotid gland. Currently, there is no standard treatment method, but the symptoms are usually relieved within a few months.