Department of Otolaryngology-Head and Neck Surgery, Lenox Hill Hospital, New York, New York, USA.
Head Neck. 2011 Oct;33(10):1539-41. doi: 10.1002/hed.21412. Epub 2010 Apr 29.
First bite syndrome is a known complication after parapharyngeal space surgery. This syndrome is usually encountered when the surgery is extensive but the parotid gland is preserved. A disruption in the balance between sympathetic and parasympathetic innervation to the parotid gland has been posited to play a role.
We report a 74-year-old woman with a parapharyngeal space malignancy who presented with first bite syndrome prior to any surgical intervention. The tumor and left parotid gland were resected via a transcervical approach. During the operation, the sympathetic chain was found to be directly involved with the tumor.
The patient reported complete resolution of first bite syndrome immediately after the operation, and remained free of this symptom at 6 months' follow-up.
To our knowledge, this is the first report of first bite syndrome presenting prior to any surgical intervention. Parotidectomy, if included in the surgical plan, may lead to the resolution of first bite syndrome.
第一口综合征是咽旁间隙手术后已知的并发症。这种综合征通常发生在手术广泛但保留腮腺时。有人提出，腮腺交感神经和副交感神经支配的平衡被打破可能起作用。
我们报告了一例 74 岁女性患有咽旁间隙恶性肿瘤，在任何手术干预之前出现第一口综合征。肿瘤和左侧腮腺通过经颈入路切除。术中发现交感链直接与肿瘤有关。
患者报告说，手术后第一口综合征立即完全缓解，6 个月随访时仍无此症状。
据我们所知，这是第一例报告在任何手术干预之前出现第一口综合征的病例。如果手术计划包括腮腺切除术，可能会导致第一口综合征的缓解。
