咽旁隙肿瘤切除术后并发初次咀嚼综合征7例的临床分析

First bite syndrome complicated by parapharyngeal space tumor resection: Clinical analysis of 7 cases

摘要:

目的 探讨分析初次咀嚼综合征(FBS)的临床特征及预后，提高临床医师对咽旁隙手术并发症的认识。方法 回顾性分析2020年1月—2025年1月就诊于湖南省人民医院耳鼻咽喉头颈外科行咽旁隙肿瘤切除手术并发FBS患者的临床资料，并通过查阅文献了解FBS的研究进展。结果 43例患者中7例患者出现FBS，发生率为16.3%，均为男性，年龄40~58岁。患者的症状表现为：每次进食，首次咀嚼时出现腮腺区域疼痛，疼痛可随咀嚼缓解，直至下次进食时复发。本组患者症状均在手术后1周内出现，多数患者的疼痛在每天的第1次进食时最为剧烈，少数患者可因想到酸性食物而诱发疼痛，部分患者疼痛可向耳后放射。所有患者的疼痛均在咀嚼后短时间内缓解。7例患者中，以神经鞘瘤多见，其次为腮腺肿瘤及其他肿瘤。5例患者的症状在1~5个月内自行缓解，1例患者的症状持续9个月无缓解，另1例患者的症状持续12个月无缓解。结论 FBS是咽旁隙手术的并发症，常在术后1周内出现，主要表现为每次进食，首次咀嚼时出现腮腺区域疼痛，疼痛可随咀嚼缓解，直至下一次进食时复发。FBS具有自限性，预后良好，多在1年左右自愈。

Abstract:

Objective To investigate the clinical characteristics and prognosis of first bite syndrome (FBS), and to improve clinicians’ understanding of complications of the parapharyngeal space surgery. Methods A retrospective analysis was conducted on the clinical data of patients with parapharyngeal space tumor resection complicated with FBS after parapharyngeal space surgery in the Department of Otorhinolaryngology Head and Neck Surgery at Hunan Provincial People’s Hospital from January 2020 and January 2025. A literature review on FBS research advancements was also performed. Results Seven cases of a total of 43 patients developed FBS, which was an incidence rate of 16.3%. All of them were male, aged 40 to 58 years. Their symptoms included parotid region pain during the first bite of the first chewing, which could be alleviated by chewing but recurring at the next times. All the symptoms of the patients in this group emerged within one week postoperatively. Most patients experienced the most severe pain during the first daily meal. A few patients could experience pain by thinking of acidic foods, and some of them had pain radiating retroauricularly. The pain of all patients was relieved shortly after the initial few chews. Among the 7 patients, schwannomas were the most common tumors, followed by parotid-derived tumors and other tumors. The symptoms of 5 patients relieved spontaneously within 1 to 5 months. The symptoms of 1 patient persisted for 9 months without relief, and the symptoms of 1 patient persisted for 12 months without relief. Conclusions FBS typically manifests within one week postoperatively, characterized by parotid pain during the first bite of each meal, alleviated by continued chewing but recurring at subsequent meals. Prognosis is favorable, with most cases resolving spontaneously within one year.