First Bite Syndrome - An Underrecognized and Underdiagnosed Pain Complication After Temporomandibular Joint Surgery.

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  • Author(s): Handa S;Handa S; Shafik AA; Shafik AA; Intini R; Intini R; Keith DA; Keith DA
  • Source:
    Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons [J Oral Maxillofac Surg] 2022 Mar; Vol. 80 (3), pp. 437-442. Date of Electronic Publication: 2021 Oct 29.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: W.B. Saunders Co Country of Publication: United States NLM ID: 8206428 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-5053 (Electronic) Linking ISSN: 02782391 NLM ISO Abbreviation: J Oral Maxillofac Surg Subsets: MEDLINE
    • Publication Information:
      Original Publication: [Philadelphia, PA : W.B. Saunders Co., c1982-
    • Subject Terms:
      Facial Pain*/diagnosis ; Facial Pain*/etiology ; Facial Pain*/surgery ; Temporomandibular Joint*/surgery; Dental Occlusion ; Humans ; Retrospective Studies ; Syndrome
    • Abstract:
      Purpose: First bite syndrome (FBS) can develop after head and neck surgical procedures. The aim of this study is to identify patients diagnosed with FSB after temporomandibular joint (TMJ) surgery, including their pain characteristics and risk factors for FBS.
      Methods: Using a retrospective study design, a cohort of 24 patients with confirmed diagnosis of FBS were identified from the oral and maxillofacial surgery and orofacial pain (OFP) practices at Massachusetts General Hospital and Research Patient Data Registry (RPDR) between 1975 and 2019. The inclusion criteria were facial pain that was triggered by taste stimulus only and followed by a refractory period until the next gustatory stimulus.
      Results: Of the 24 patients identified, 19 had undergone TMJ surgery, 3 patients had idiopathic FBS, 1 had a parapharyngeal space tumor and 1 developed FBS after facial burns. In the surgical patients, the median duration of onset was 2.75 months post-surgery. Most patients reported pain in the parotid region. Pain was only triggered by a taste stimulus and subsided with subsequent bites of food. 2 patients underwent spontaneous resolution of their symptoms and 1 reported complete resolution with onabotulinum toxin A (BTX) injections. Anxiety and depression were the most common comorbid conditions.
      Conclusion: FBS is an underrecognized pain complication in TMJ surgery patients. A precise history and accurate description of the pain is necessary for correct diagnosis which is important for improved treatment outcomes.
      (Copyright © 2021 The American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)
    • Publication Date:
      Date Created: 20211128 Date Completed: 20220324 Latest Revision: 20220324
    • Publication Date:
      20240829
    • Accession Number:
      10.1016/j.joms.2021.10.012
    • Accession Number:
      34838508