title: Treatment of the first bite syndrome.
abstract: First bite syndrome is a potential complication of surgery involving the infratemporal fossa, deep lobe of the parotid gland and parapharyngeal space. It is described as an acute and intense pain in the parotid region caused with the first bite of each meal. It is related to damage to sympathetic innervation of the parotid gland. Parasympathetic hyperactivation is believed to stimulate an exaggerated myoepithelial cell contraction causing pain. Usual analgesic treatments have poor results. Botulinum toxin type A causes parasympathetic nerve paralysis of the parotid gland and this fact would minimize salivation and decrease first bite syndrome. The aim of this study is to show the details of the technique and our outcomes in 5 patients treated with botulinum toxin type A.
authors.affiliation: Hospital Universitario Marqués de Valdecilla, Santander, España. Electronic address: costi2@hotmail.com.
authors.forename: María
authors.initials: M
authors.lastname: Costales-Marcos
authors.affiliation: Hospital Universitario Central de Asturias, Oviedo, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: López Álvarez
authors.affiliation: Hospital Universitario Central de Asturias, Oviedo, España.
authors.forename: Laura
authors.initials: L
authors.lastname: Fernández-Vañes
authors.affiliation: Hospital Universitario Central de Asturias, Oviedo, España.
authors.forename: Justo
authors.initials: J
authors.lastname: Gómez
authors.affiliation: Hospital Universitario Central de Asturias, Oviedo, España.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Llorente
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000008:administration & dosage*; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008409:Mastication; D059408:Pain Management / Q000379:methods*; D010306:Parotid Gland / Q000601:surgery; D011183:Postoperative Complications / Q000188:drug therapy*; D013577:Syndrome
chemical_list: D065087:Acetylcholine Release Inhibitors; D019274:Botulinum Toxins, Type A
keywords: Botulinum toxin; First bite syndrome; Parotid; Parótida; Síndrome del primer mordisco; Toxina botulínica