First bite syndrome: our experience of laser tympanic plexus ablation.
BACKGROUND
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.


CONCLUSIONS
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.
Department of Otorhinolaryngology/Head and Neck Surgery, Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Brighton, UK.
N
N
Amin
Department of Otorhinolaryngology/Head and Neck Surgery, Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Brighton, UK.
A
A
Pelser
Department of Otorhinolaryngology/Head and Neck Surgery, Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Brighton, UK.
J
J
Weighill
D000368:Aged; D004432:Ear, Middle / Q000294:innervation* / Q000601:surgery; D005157:Facial Pain / Q000601:surgery*; D005260:Female; D005930:Glossopharyngeal Nerve / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008409:Mastication; D013577:Syndrome