Pre-operative Occurrence of First Bite Syndrome in Two Cases of Parotid Gland Tumour.

Introduction: First bite syndrome (FBS) is a gustatory-evoked painful condition that is characterised by the onset of severe electric shock-like pain in the periauricular region. In the majority of patients, FBS develops postoperatively. However, in rare instances, it may present in a pre-operative setting.

Case description: Two cases of FBS developing preoperatively secondary to parotid gland tumour are presented. The patients, 54 and 30 years old, presented with complaints of electric shock-like pain localised over the periauricular region. In each case, the pain was triggered following the first bite of the meal. In both cases, the pain lasted for few seconds and with subsequent bites subsided only to return at the beginning of the next meal.

Practical implications: Pre-operative occurrence of FBS in the absence of a history of trauma or surgery should necessitate a thorough investigation and follow-up for an underlying salivary gland tumour.