A case of preoperative "first-bite syndrome" associated with mucoepidermoid carcinoma of the parotid gland

Abstract

First-bite syndrome, characterized by excruciating pain in the parotid region after the first few bites of food, can be seen after surgery of the parapharyngeal space. Herein we describe a patient with no prior surgical history who presented with facial pain consistent with first-bite syndrome. Imaging and ultrasound-guided FNA revealed a nonpalpable mucoepidermoid carcinoma of the parotid gland, which was removed surgically with facial nerve preservation. After surgical intervention, the patient's symptoms resolved. An extensive literature review demonstrated that this is the first description of a preoperative first-bite syndrome, or first-bite syndrome associated with the presence a parotid mass.