Novel treatment of first bite syndrome using botulinum toxin type A

Abstract

The BTA injection into affected parotid gland produces a decrease in the severity of first bite syndrome and improves the patient's quality of life.

Atypical Complications Following Surgical Excision of Carotid Body Tumours

“…improving one's quality of life. 20 Such evidence makes BTA a promising treatment option for the patient presented in Case 2, and other patients experiencing similar post-surgical facial spasms.…”

“…BTA works by blocking the transmission of parasympathetic impulses, specifically preventing the release of acetylcholine from the pre-synaptic neuron to various muscle and glandular tissues. 20 is translates into a reduction of pathological glandular secretion and movement. Due to its efficacy, minimally invasive nature, and the rarity of side effects, it has become a mainstay treatment for numerous disorders of the head and neck region.…”

First-Bite syndrome and Eagle syndrome

“…FBS is described as occurring following a surgical procedure in the paracervical region because of a lesion of the sympathetic nerve fibers innervating the parotid gland [6]. ES is described following SHL ossification.…”

“…Ali et al expected a recurrence of symptoms 4-6 months after the injection and scheduled the patient for a new BT injection. Lee et al divided BT injection into three doses of 11 IU of BT each, diluted in a physiological serum solution, for a total of 33 IU; they observed a significant difference in pain during eating and quality of life at 3 months in five patients [6]. Costaes-Marcos et al treated five patients with three concurrent injections of 10 IU of BT injected into the parotid gland.…”

“…This loss of nerve function is responsible for the denervation of sympathetic receptors of the myoepithelial parotid cells. These cells also have parasympathetic receptors, which become hypersensitive to a parasympathetic stimulation, resulting in intense maximum contraction when taking the first bite, which subsequently induces head and neck pain and/or cramps [6].…”