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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: n.amin@doctors.org.uk
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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 

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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