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First bite syndrome: our experience of laser tympanic plexus ablation

Published online by Cambridge University Press:  24 January 2014

N Amin*
Affiliation:
Department of Otorhinolaryngology/Head and Neck Surgery, Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Brighton, UK
A Pelser
Affiliation:
Department of Otorhinolaryngology/Head and Neck Surgery, Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Brighton, UK
J Weighill
Affiliation:
Department of Otorhinolaryngology/Head and Neck Surgery, Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Brighton, UK
*
Address for correspondence: Mr Nikul Amin, 34 Wykeham Rd, Kenton HA3 8LJ, UK E-mail: n.amin@doctors.org.uk

Abstract

Introduction:

First bite syndrome is a condition characterised by severe facial pain brought on by the first bite of each meal. This can severely affect the patient's ability to eat.

Methods:

We present a 70-year-old woman for whom we performed a laser ablation of the left ear tympanic plexus, as treatment of first bite syndrome. A permeatal approach was used to raise a tympanomeatal flap. The tympanic plexus was identified on the promontory and a 4 mm2 area of the plexus was ablated using CO2 laser. The flap was repositioned and a dressing was placed with topical antibiotics.

Results:

At two-month follow up, there was full resolution of the patient's symptoms.

Discussion:

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.

Type
Short Communications
Copyright
Copyright © JLO (1984) Limited 2014 

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