{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T21:19:16Z","timestamp":1793049556990,"version":"4.5.0"},"reference-count":14,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Description<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Practical Implications<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.37029\/jcas.v6i1.331","type":"journal-article","created":{"date-parts":[[2020,1,6]],"date-time":"2020-01-06T02:12:19Z","timestamp":1578276739000},"page":"1-5","source":"Crossref","is-referenced-by-count":1,"title":["Pre-operative Occurrence of First Bite Syndrome in Two Cases of Parotid Gland Tumour"],"prefix":"10.2478","volume":"6","author":[{"given":"Khawaja Shehryar","family":"Nasir","sequence":"first","affiliation":[{"name":"Department of Internal Medicine , Shaukat Khanum Memorial Cancer Hospital and Research Centre , Lahore , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raza","family":"Hussain","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology , Shaukat Khanum Memorial Cancer Hospital and Research Centre , Lahore , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arif","family":"Jamshed","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology , Shaukat Khanum Memorial Cancer Hospital and Research Centre , Lahore , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2020,1,5]]},"reference":[{"key":"2026091912310640862_j_jcas.v6i1.331_ref_001","unstructured":"Scrivani SJ, Keith DA, Kulich R, Mehta N, Maciewicz RJ. Posttraumatic gustatory neuralgia: A clinical model of trigeminal neuropathic pain. J Orofac Pain 1998;12:287-92."},{"key":"2026091912310640862_j_jcas.v6i1.331_ref_002","doi-asserted-by":"crossref","unstructured":"Netterville JL, Jackson CG, Miller FR, Wanamaker JR, Glasscock ME. Vagal paraganglioma: A review of 46 patients treated during a 20-year period. Arch Otolaryngol Head Neck Surg 1998;124:1133-40.","DOI":"10.1001\/archotol.124.10.1133"},{"key":"2026091912310640862_j_jcas.v6i1.331_ref_003","doi-asserted-by":"crossref","unstructured":"Laccourreye O, Werner A, Garcia D, Malinvaud D, Tran Ba Huy P, Bonfils P. First bite syndrome. Eur Ann Otorhinolaryngol Head Neck Dis 2013;130:269-73.","DOI":"10.1016\/j.anorl.2012.11.003"},{"key":"2026091912310640862_j_jcas.v6i1.331_ref_004","doi-asserted-by":"crossref","unstructured":"Avin\u00e7sal M\u00d6, Hiroshima Y, Shinomiya H, Shinomiya H, Otsuki N, Nibu KI. First bite syndrome an 11-year experience. Auris Nasus Larynx 2017;44:302-5.","DOI":"10.1016\/j.anl.2016.07.012"},{"key":"2026091912310640862_j_jcas.v6i1.331_ref_005","doi-asserted-by":"crossref","unstructured":"Linkov G, Morris LG, Shah JP, Kraus DH. First-bite syndrome: Incidence, risk factors, treatment, and outcomes. J Neurol Surg Part B 2012;73:A126.","DOI":"10.1055\/s-0032-1312174"},{"key":"2026091912310640862_j_jcas.v6i1.331_ref_006","doi-asserted-by":"crossref","unstructured":"Diercks GR, Rosow DE, Prasad M, Kuhel WI. A case of preoperative \u201cfirst-bite syndrome\u201d associated with mucoepidermoid carcinoma of the parotid gland. Laryngoscope 2011;121:760-2.","DOI":"10.1002\/lary.21282"},{"key":"2026091912310640862_j_jcas.v6i1.331_ref_007","doi-asserted-by":"crossref","unstructured":"Lieberman SM, Har-El G. First bite syndrome as a presenting symptom of a parapharyngeal space malignancy. Head Neck 2011;33:1539-41.","DOI":"10.1002\/hed.21412"},{"key":"2026091912310640862_j_jcas.v6i1.331_ref_008","doi-asserted-by":"crossref","unstructured":"Guss J, Ashton-Sager AL, Fong BP. First bite syndrome caused by adenoid cystic carcinoma of the submandibular gland. Laryngoscope 2013;123:426-8.","DOI":"10.1002\/lary.23725"},{"key":"2026091912310640862_j_jcas.v6i1.331_ref_009","doi-asserted-by":"crossref","unstructured":"Deganello A, Meccariello G, Busoni M, Franchi A, Gallo O. First bite syndrome as presenting symptom of parapharyngeal adenoid cystic carcinoma. J Laryngol Otol 2011;125:428-31.","DOI":"10.1017\/S002221511000294X"},{"key":"2026091912310640862_j_jcas.v6i1.331_ref_010","doi-asserted-by":"crossref","unstructured":"Stenner M, Klussmann JP. Current update on established and novel biomarkers in salivary gland carcinoma pathology and the molecular pathways involved. Eur Arch Otorhinolaryngol 2009;266:333-41.","DOI":"10.1007\/s00405-008-0882-7"},{"key":"2026091912310640862_j_jcas.v6i1.331_ref_011","doi-asserted-by":"crossref","unstructured":"Pinkston JA, Cole P. Incidence rates of salivary gland tumors: Results from a population-based study. Otolaryngol Head Neck Surg 1999;120:834-40.","DOI":"10.1016\/S0194-5998(99)70323-2"},{"key":"2026091912310640862_j_jcas.v6i1.331_ref_012","doi-asserted-by":"crossref","unstructured":"Gandolfi MM, Slattery W 3rd. Parotid gland tumors and the facial nerve. Otolaryngol Clin North Am 2016;49:425-34.","DOI":"10.1016\/j.otc.2015.12.001"},{"key":"2026091912310640862_j_jcas.v6i1.331_ref_013","doi-asserted-by":"crossref","unstructured":"Teymoortash A, Krasnewicz Y, Werner JA. Clinical features of cystadenolymphoma (Warthin\u2019s tumor) of the parotid gland: A retrospective comparative study of 96 cases. 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