{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T15:42:20Z","timestamp":1776786140447,"version":"3.51.2"},"reference-count":0,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T00:00:00Z","timestamp":1729468800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215124001555_sec1a\"><jats:title>Objective<\/jats:title><jats:p>First bite syndrome refers to pain in the parotid region during the first bite when eating that improves with subsequent bites. There is a paucity of evidence in the literature to justify recommending optimal management therefore this study aimed to review the latest evidence for its management.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215124001555_sec2b\"><jats:title>Methods<\/jats:title><jats:p>A literature search across four databases was conducted using a Population, Intervention, Comparison, Outcome-generated search strategy between 2012 and 2022. Screening was done by two reviewers according to pre-determined inclusion and exclusion criteria, demonstrated in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215124001555_sec3c\"><jats:title>Results<\/jats:title><jats:p>Eleven articles were included. Six articles used repeated botulinum toxin injection, which in all the studies resulted in complete symptoms resolution. Four articles found a watch-and-wait technique to be effective. There were conflicting results on the efficacy of medical treatments such as opioids or anticonvulsants.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215124001555_sec4d\"><jats:title>Conclusion<\/jats:title><jats:p>Studies have shown that first bite syndrome symptoms eventually resolve with conservative management, but repeated botulinum toxin appeared efficacious for quicker symptom resolution. Further higher-quality studies should be conducted to identify the optimal management.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215124001555","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T08:10:10Z","timestamp":1729498210000},"page":"258-265","source":"Crossref","is-referenced-by-count":2,"title":["Management of first bite syndrome: systematic review of recent evidence"],"prefix":"10.1017","volume":"139","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4912-4958","authenticated-orcid":false,"given":"Wan Wei","family":"Ang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ee Teng","family":"Goh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8674-9116","authenticated-orcid":false,"given":"Juliet","family":"Laycock","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2024,10,21]]},"container-title":["The Journal of Laryngology &amp; Otology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0022215124001555","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T08:08:15Z","timestamp":1747987695000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0022215124001555\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,21]]},"references-count":0,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["S0022215124001555"],"URL":"https:\/\/doi.org\/10.1017\/s0022215124001555","relation":{},"ISSN":["0022-2151","1748-5460"],"issn-type":[{"value":"0022-2151","type":"print"},{"value":"1748-5460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,21]]}}}