Patients undergoing surgery with potential compromise of these anatomical sites and structures should be thoroughly counseled about the risk of developing FBS. Out of 16 FBS patients interviewed, only 2 (13%) recall being informed of the risk of FBS before surgery, but 9 (56%) stated that they would have liked to know.Ĭonclusions: The strongest independent risk factors for FBS are: PPS dissection, deep lobe of parotid resection, and sympathetic chain sacrifice. No treatment consistently provided effective symptomatic relief. Of 45 FBS patients, 15 (33%) underwent at least one type of treatment for symptomatic relief. Partial resolution of FBS symptoms occurred in 69%, and complete resolution in 13%. FBS developed in 48.6% of patients undergoing sympathetic chain sacrifice, 22.4% of patients undergoing PPS dissection, 38.4% of patients undergoing deep lobe parotid resection, and 0.8% of patients undergoing total parotidectomy. On multivariable analysis, three variables were significant independent risk factors for FBS: sympathetic chain sacrifice (OR 4.7, P = 0.008), PPS dissection (OR 8.7, P = 0.001), and resection of only the deep lobe of the parotid gland (OR 4.2, P = 0.002). Results: FBS developed in 45 patients (9.6%), at mean time of 97 (6–877) days from surgery. Patients developing FBS were interviewed by phone. Univariate analyses and a multivariable logistic regression model were used to identify independent risk factors for FBS. Incidence was calculated using the Kaplan-Meier method. Conclusions: Many treatments for first bite syndrome have been attempted including: dietary modification, pharmacological treatments, and surgical treatments. Patient, tumor, and FBS characteristics were analyzed. All patients were followed for a minimum of 3 months postoperatively. Methods: We reviewed the charts of 499 patients (mean age, 50 years range 12–81 years) undergoing surgery of the deep lobe of the parotid gland, PPS, and ITF between 19. The incidence, risk factors, treatment options, and outcomes of FBS remain poorly defined. It is a potential sequela of surgery involving the infratemporal fossa (ITF), parapharyngeal space (PPS), and deep lobe of the parotid gland. Background: First-bite syndrome (FBS) refers to pain in the parotid region after the first bite of a meal. First Bite Syndrome Treatment Behavioral changes: patient is asked to do some actions like quenching fists, and rubbing cheeks to distract attention.
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