A majority of these symptoms resolve over time. It is currently thought this is likely due to sympathetic denervation of the parotid gland due to severing of the CSC resulting in hypersensitivity of the sympathetic receptors. With subsequent bites, the pain often decreases. Botulinum toxin was injected within the parotid gland for symptom management.ĭiscussion: In First Bite Syndrome, pain in the parotid area can be severe with the first bite of food. Following right parotid gland ultrasound examination, the patient was diagnosed with First Bite Syndrome. Approximately one month later, the patient complained of discomfort in her mouth and jaw on initiating a meal. Fiber-optic laryngoscopy revealed subtle right VC weakness that improved by post-operative day #5. On post-operative day #1, the patient had normal tongue mobility, intact CN 7 function, slight ptosis of the right eye and symmetric pupils without miosis. Histopathologic examination revealed the mass to be likely consistent with a schwannoma. It measured 5.7 cm in the largest dimension and was attached to a nerve bundle, possibly the CSC. The right-sided mass was free from the jugular vein, carotid artery, and CN 10. The patient consented to mass excision and right neck dissection that was performed by an otolaryngologist and cardiovascular surgeon. CT demonstrated the mass as measuring 3.6 x 3.5 x 4.9 cm with close adherence to the right carotid artery. Flexible fiber-optic laryngoscopy revealed R vocal cord (VC) sluggishness with poor abduction. The mass was non-tender and firm with a 4-5 cm diameter oriented vertically. The patient complained of locally compressive symptoms including bilateral neck pain, dizziness, dysphagia and hoarseness. Post-operative complications involved with removing the CSC include Horner’s syndrome (almost inevitable) and First Bite Syndrome.Ĭase Description: An 80-year-old female presented with a 7-year history of an enlarging right neck mass followed serially over time with moderate growth. Although cervical sympathetic chain (CSC) schwannomas are uncommon, they are known for their ability to mimic the physical and radiologic findings of carotid body tumors. InSickness - A sub for partners of the chronically ill.Introduction: Most schwannomas, other than those associated with neurofibromatosis, occur in the para-pharyngeal space often originating from Cranial nerves (CN) 9-12 or the sympathetic chain. (Please read their sidebars for posting rules prior to posting!) Sometimes, simply venting helps! We have an official Discord server! Come on in and say hi! Posting about how you feel is quite alright, but please don't ask for advice about how to end it all. We will remove posts soliciting or giving advice about suicide. Most insurance offers nurse help lines as well. There's also an FAQ about what to expect when calling.įor medical help, the emergency room is always the first choice. You can find a list of crisis hotlines on this wiki. If you're unsure whether your content fits self promotion, feel free to message the mods. In cases where lack of community participation, excessive links/posts, or if content is better suited for ads, it may be removed and/or you could be banned. We try to follow Reddits self promotion guidelines when determining if content is acceptable or not. Do not post anything regarding the misuse or abuse of your medications. To protect users from harmful and improper management of survey data and unpaid usage of our communities time (a chance to win a giftcard is not compensation for the time and effort of humans).Īll posts soliciting or giving advice about how to obtain specific (or groups) of medications will be removed. NO POSTING OF SURVEYS, STUDIES, OR RESEARCH PROJECTS! If it's bad enough that you feel the need to post about it then it's probably bad enough that you should go to a doctor. You don't know how your advice might affect another person's well-being, no matter how well your intentions might be.ĭO NOT POST ABOUT YOUR PAIN IF YOU HAVEN'T SEEN A DOCTOR RECENTLY. Sharing your failures or successes concerning your experiences with treatments is fine. Soliciting or giving medical advice is strictly forbidden in this subreddit. While reddit does not explicitly ban medical advice in their ToS anymore, it is best to avoid giving medical advice over the internet in general. NOBODY HERE IS A VERIFIED MEDICAL PROFESSIONAL
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