Abstract
Background: For the first bite syndrome (FBS), various causes were suggested such as parapharyngeal space surgery, resection of styloid process, carotid endarterectomy, parotid gland tumor, submandibular gland tumor, and upper cervical surgery. Actually, the real cause of FBS is still not clear. Also, suggested methods of treatment for the FBS are botulinum toxin injection, laser tympanic plexus ablation, pharmacologic approach, and no treatment. The results of those treatments were not satisfactory. Aim: The authors tried to find out the adequate method of treatment for the FBS and also tried to figure out pathologic cause of the FBS through observation of the patient response to the treatment. Case Presentation: A 38-year-old male was presented at head and neck surgery clinic with a sharp pain on the left parotid area especially at the first bite of eating food for two days. There was no cause. The patient was given trigger point injections on his left sternocleidomastoid, masseter, and temporal muscles with left mandibular nerve block five times 3 - 4 days apart. Also small amount of oral anticonvulsants were added for four weeks. Before finishing taking oral medication, the pain was gone completely. Conclusion: The authors experienced a case of FBS with no detectable cause, and treated successfully with the methods of trigger point injection, mandibular nerve block, and oral antiepileptic medication.
Highlights
First bite syndrome (FBS) refers to facial pain characterized by a severe cramping or spasm in the parotid regionHow to cite this paper: Chang, S.H., Jun, B.S., Choi, J.O., Kim, J.J. and Jang, Y. (2015) Successful Treatment of a Case of First Bite Syndrome without Any Cause
It is supposed to be a potential sequela of surgery involving the infratemporal fossa (ITF), parapharyngeal space (PPS), and/or deep lobe of the parotid gland
The authors came upon a patient with first bite syndrome (FBS) for 20 days without any cause, and manipulated the syndrome successfully with the methods of trigger point injections, mandibular nerve block, and combined small amount of anticonvulsants carbamazepine and neurontin
Summary
First bite syndrome (FBS) refers to facial pain characterized by a severe cramping or spasm in the parotid region. How to cite this paper: Chang, S.H., Jun, B.S., Choi, J.O., Kim, J.J. and Jang, Y. (2015) Successful Treatment of a Case of First Bite Syndrome without Any Cause. It is supposed to be a potential sequela of surgery involving the infratemporal fossa (ITF), parapharyngeal space (PPS), and/or deep lobe of the parotid gland. The incidence, risk factors, treatment options, and outcomes of FBS are poorly understood [1]. The authors came upon a patient with FBS for 20 days without any cause, and manipulated the syndrome successfully with the methods of trigger point injections, mandibular nerve block, and combined small amount of anticonvulsants carbamazepine and neurontin
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