Vol.99 No.9 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 99 No. 9 September 2006
First Bite Syndrome after Dissection
of Parapharyngeal Tumor
Hideyuki Nakagawa
(Kochi National Hospital)
Koichi Tamura, Koji Abe, Katsushi Miyazaki,
Hironori Akizuki and Noriaki Takeda
(University of Tokushima School of Medicine)
Two cases of first bite syndrome (FBS) were reported as a complication after surgery for parapharyngeal tumor. FBS is the development of pain in the parotid area associated with the first bite of food, especially the first meal of the day. In one case, pleomorphic adenoma of the left parotid gland extended into the parapharyngeal space. During resection, dissection around the external carotid artery was performed to mobilize the parotid tail and part of the parotid gland tissue was preserved. In the other case, acinic cell carcinoma of the left parapahryngeal space was resected. During resection, the external carotid artery was cut and most of the parotid gland was preserved. In both cases, sympathetic innervation of the parotid gland through the sympathetic plexus around the external carotid artery was lost without Horner's syndrome. It is possible that sympathectomy of the residual parotid gland is responsible for the development of FBS.
Key words : first bite syndrome, parapharyngeal tumor, complication