両側性に発症した特発性first bite syndromeの1症例

DOI Web Site 参考文献14件
  • 千葉 雅俊
    東北大学大学院歯学研究科口腔病態外科学講座口腔外科学分野
  • 廣谷 拓章
    東北大学大学院歯学研究科口腔病態外科学講座口腔外科学分野
  • 越後 成志
    東北大学大学院歯学研究科口腔病態外科学講座口腔外科学分野

書誌事項

タイトル別名
  • Bilateral idiopathic first bite syndrome: a case report
  • リョウガワセイ ニ ハッショウ シタ トクハツセイ first bite syndrome ノ 1 ショウレイ

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First bite syndrome (FBS) is an unusual disease, which is characterized by excruciating pain in the parotid region after the first bite, and is usually seen after parapharyngeal space surgery. We report on a 33-year-old man, with no prior surgical history, who presented with bilateral orofacial pain consistent with FBS. The patient complained of severe pain in the parotid region and impacted upper wisdom teeth, which had been occurring for two months. The intense pain appeared to be related to the first few bites eaten at every meal, and the pain improved with each subsequent bite. Symptoms were severe enough to hinder his quality of life. On examination, the parotid glands, temporomandibular joints and teeth were normal. MRI of the head and face did not detect any intracranial or extracranial pathologic lesion, with the exception of hypertrophy of parotid glands. Although chewing gauze did not induce pain, the application of acetic acid, which stimulates salivation to the anterior part of the tongue, triggered sharp pain in the parotid glands. Conservative therapy, including drug therapy and self-care, began with a limited effect initially, but the severity of pain improved slowly and at six months, his symptoms had almost resolved. These findings suggest that the gustatory-salivary reflex via the chorda tympani fibers is involved in the development of pain of the idiopathic FBS. We think that patients with orofacial pain consistent with FBS should undergo MRI of the face to rule out parotid or parapharyngeal space lesion.

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