Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-28T06:51:09.679Z Has data issue: false hasContentIssue false
  • English
  • Français

First bite syndrome: our experience of laser tympanic plexus ablation

Published online by Cambridge University Press:  24 January 2014

N Amin ,
A Pelser  and
J Weighill
N Amin*
Affiliation:
Department of Otorhinolaryngology/Head and Neck Surgery, Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Brighton, UK
A Pelser
Affiliation:
Department of Otorhinolaryngology/Head and Neck Surgery, Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Brighton, UK
J Weighill
Affiliation:
Department of Otorhinolaryngology/Head and Neck Surgery, Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Brighton, UK
*
Address for correspondence: Mr Nikul Amin, 34 Wykeham Rd, Kenton HA3 8LJ, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

First bite syndrome is a condition characterised by severe facial pain brought on by the first bite of each meal. This can severely affect the patient's ability to eat.

Methods:

We present a 70-year-old woman for whom we performed a laser ablation of the left ear tympanic plexus, as treatment of first bite syndrome. A permeatal approach was used to raise a tympanomeatal flap. The tympanic plexus was identified on the promontory and a 4 mm2 area of the plexus was ablated using CO2 laser. The flap was repositioned and a dressing was placed with topical antibiotics.

Results:

At two-month follow up, there was full resolution of the patient's symptoms.

Discussion:

First bite syndrome carries a high morbidity; treatment options are variable, and often unsuccessful. We describe the first documented case of laser tympanic plexus ablation, with a very effective initial response. This procedure represents a useful therapeutic option for first bite syndrome.

Keywords

Tympanic CavityParotid DiseasesLasers
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 2 , February 2014 , pp. 166 - 168
Copyright
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Linkov, G, Morris, LG, Shah, JP, Kraus, DH. First bite syndrome: incidence, risk factors, treatment, and outcomes. Laryngoscope 2012;122:1773–8CrossRefGoogle ScholarPubMed
2Chiu, AG, Cohen, JI, Burningham, AR, Andersen, PE, Davidson, BJ. First bite syndrome: a complication of surgery involving the parapharyngeal space. Head Neck 2002;24:996–9Google Scholar
3Haubrich, WS. The first-bite syndrome. Henry Ford Hosp Med J 1986;34:275–8Google Scholar
4Netterville, JL, Jackson, CG, Miller, FR, Wanamaker, JR, Glasscock, ME. Vagal paraganglioma: a review of 46 patients treated during a 20-year period. Arch Otolaryngol Head Neck Surg 1998;124:1133–40CrossRefGoogle Scholar
5Trenery, A, Qureshi, ZP, Rowen, R, Day, R, Norris, L, Bennett, CL. First-bite syndrome: a novel complication of carotid body paraganglioma resection. Commun Oncol 2011;8:375–8Google Scholar
6Kawashima, Y, Sumi, T, Sugimoto, T, Kishimoto, S. First-bite syndrome: a review of 29 patients with parapharyngeal space tumor. Auris Nasus Larynx 2008;35:109–13Google Scholar
7Ali, MJ, Orloff, LA, Lustig, LR, Eisele, DW. Botulinum toxin in the treatment of first bite syndrome. Otolaryngol Head Neck Surg 2008;139:742–3CrossRefGoogle ScholarPubMed
8Vasama, JP. Tympanic neurectomy and chronic parotitis. Acta Otolaryngol 2000;120:995–8CrossRefGoogle ScholarPubMed