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

Ear Nose Throat J. 2022 Dec;101(10):663-667. doi: 10.1177/0145561320980179. Epub 2020 Dec 14.

Abstract

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.

Keywords: deep lobe of parotid gland; first bite syndrome; pain syndrome; parotidectomy; postoperative quality of life.

Publication types

  • Review

MeSH terms

  • Facial Pain
  • Humans
  • Mastication*
  • Parotid Gland / surgery
  • Parotid Neoplasms* / surgery
  • Parotid Region
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Syndrome