Pre-operative Occurrence of First Bite Syndrome in Two Cases of Parotid Gland Tumour

Abstract

Introduction: First bite syndrome (FBS) is a gustatory-evoked painful condition that is characterized by the onset of severe electric-shock like pain in the periauricular region. In the majority of patients, FBS develops post-operatively. However, in rare instances it may present in a preoperative setting. Case description: Two cases of FBS developing preoperatively secondary to parotid gland tumour are presented. The patients, 54 and 30 years old, presented with complaints of electric-shock like pain localized over the periauricular region. In each case the pain was triggered following first bite of the meal. In both cases, pain lasted for a few seconds and with subsequent bites subsided only to return at the beginning of next meal. Practical implications: Preoperative occurrence of FBS in the absence of a history of trauma or surgery should necessitate a thorough investigation and follow up for an underlying salivary gland tumour.

Keywords

• Cancer pain
• first bite syndrome
• neuralgia
• parotid neoplasms