First Bite Syndrome After Parotidectomy: A Case Series and Review of Literature

• Published in: Ear, nose, & throat journal Vol. 101; no. 10; pp. 663 - 667
• Main Authors: Xu, Vivian, Gill, Kurren S., Goldfarb, Jared, Bovenzi, Cory, Moayer, Roxana, Krein, Howard, Heffelfinger, Ryan
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.12.2022; SAGE PUBLICATIONS, INC
• Subjects: Exocrine glands; Neurological disorders; Otolaryngology; Pain; Surgical outcomes; pain syndrome; first bite syndrome; deep lobe of parotid gland; parotidectomy; postoperative quality of life
• ISSN: 0145-5613; 1942-7522
• DOI: 10.1177/0145561320980179

Introduction: First bite syndrome (FBS) is a rare but potentially debilitating complication observed after surgery involving the upper cervical region. Patients classically complain of severe facial pain in the ipsilateral parotid region with the first few bites of a meal. Objective: The aim of this study is to shed light on the incidence and potential risk factors of FBS, including a series of cases depicting FBS observed after parotidectomy. Methods: Retrospective review of 419 patients who underwent parotidectomy at a single tertiary care facility between December 2016 and June 2020. Results: With a mean follow-up time of 16.5 months, 8 (2%) patients were documented to have symptoms of FBS after parotid gland surgery. Six of these patients underwent partial parotidectomy by dissection of the deep lobe of the parotid (DLP). Conclusion: Patients undergoing dissection of the DLP are particularly at risk for the development of FBS. All patients should be appropriately counseled during informed consent discussions, especially in high-risk cases.