First Bite Syndrome: A Rare Post-Surgical Complication Following a Carotid Body Tumor Excision.

First bite syndrome (FBS) is characterized by intense pain in the parotid area that starts with the first bite of food spontaneously. FBS is an uncommonly observed surgical complication of head and neck surgery. A 36-year-old male patient reported extreme pain after surgical excision of a carotid body tumor (CBT) in the ipsilateral parotid gland region at the first bite of each food intake, which improves gradually with continued mastication. Several factors are believed to be responsible for this phenomenon, including injury or amputation of the cervical sympathetic trunk. Loss of sympathetic innervation makes the parotid gland hypersensitive to parasympathetic stimulation. The best treatment for FBS is not yet firmly established, even though symptoms tend to improve with time in some cases. We report this case of FBS after CBT excision to raise awareness among maxillofacial surgeons of this surgical complication.