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.

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SummaryTwenty-one total pharyngo-laryngectomies have been performed at the Manchester Royal Infirmary between 1968 and 1982. A variety of methods of repair have been used, gastric transposition being the most common. Seventeen patients had received previous radiotherapy to the area, fourteen radical, two palliative and one to a supraglottic carcinoma 12 years before. Four had tumours judged to be too large to benefit from radiotherapy.Of the patients who received radiotherapy, fourteen had a good response with palliation for an average of ten months before symptoms began to return.Four patients survived over five years post-operatively and ten died following surgery.

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