Abstract：
OBJECTIVE: First bite syndrome (FBS) is a rare complication of transoral surgery (TOS) for oropharyngeal cancer (oropharyngeal squamous cell carcinoma [OPSCC]). Risk factors for developing this complication are not well described. In this study, we attempt to identify risks for developing FBS in TOS.
METHODS: Retrospective chart review.
METHODS: Tertiary care medical center.
METHODS: This study was exempted by the Mayo Clinic institutional review board. We performed a review from January 2017 to November 2022 of all patients who underwent TOS for OPSCC by a single provider. Exclusion criteria included less than 6 months follow up, prior treatment of head and neck cancer, or incomplete records. Demographic data, comorbidities, tumor characteristics, surgical details, adjuvant treatment details, functional outcomes, and oncologic outcomes were assessed. Fisher\'s Exact test and Kruskal-Wallis rank sum test were used to identify significant variables, and multivariable logistic regression was used to address confounding.
RESULTS: One hundred and one patients were identified. Eighty-nine met the inclusion criteria. The mean follow-up was 34 months (median 33). Seven patients (7.9%) developed FBS. Palatine tumor primary (P = .041), resection of styloglossus/stylopharyngeus (P = .039), and parapharyngeal fat manipulation (P = .015) were associated with the presence of FBS. After adjusting for tumor location, manipulation of parapharyngeal fat maintained significance (P = .025). T and N staging, tumor volume, adjuvant radiation, and ligation of lingual/facial arteries were not associated with the development of FBS. Eighty-six percent (6/7) of patients had a resolution of FBS at an average of 11.3 months.
CONCLUSIONS: Manipulation of the parapharyngeal space is independently associated with developing FBS in TOS in our cohort. Further confirmatory studies are warranted.
METHODS: Retrospective chart review.
METHODS: Tertiary care medical center.
METHODS: This study was exempted by the Mayo Clinic institutional review board. We performed a review from January 2017 to November 2022 of all patients who underwent TOS for OPSCC by a single provider. Exclusion criteria included less than 6 months follow up, prior treatment of head and neck cancer, or incomplete records. Demographic data, comorbidities, tumor characteristics, surgical details, adjuvant treatment details, functional outcomes, and oncologic outcomes were assessed. Fisher\'s Exact test and Kruskal-Wallis rank sum test were used to identify significant variables, and multivariable logistic regression was used to address confounding.
RESULTS: One hundred and one patients were identified. Eighty-nine met the inclusion criteria. The mean follow-up was 34 months (median 33). Seven patients (7.9%) developed FBS. Palatine tumor primary (P = .041), resection of styloglossus/stylopharyngeus (P = .039), and parapharyngeal fat manipulation (P = .015) were associated with the presence of FBS. After adjusting for tumor location, manipulation of parapharyngeal fat maintained significance (P = .025). T and N staging, tumor volume, adjuvant radiation, and ligation of lingual/facial arteries were not associated with the development of FBS. Eighty-six percent (6/7) of patients had a resolution of FBS at an average of 11.3 months.
CONCLUSIONS: Manipulation of the parapharyngeal space is independently associated with developing FBS in TOS in our cohort. Further confirmatory studies are warranted.
摘要：
目标：首次咬伤综合征（FBS）是经口手术（TOS）治疗口咽鳞癌（口咽鳞癌[OPSCC]）的罕见并发症。没有很好地描述发生这种并发症的危险因素。在这项研究中,我们试图确定在TOS中发展FBS的风险。
方法：回顾性图表回顾。
方法：三级医疗中心。
方法：这项研究被梅奥诊所机构审查委员会豁免。我们从2017年1月至2022年11月对所有接受OPSCCTOS的患者进行了审查。排除标准包括少于6个月的随访，头颈癌的先前治疗，或不完整的记录。人口统计数据,合并症,肿瘤特征，手术细节,辅助治疗细节，功能结果，并评估肿瘤结局.Fisher精确检验和Kruskal-Wallis秩和检验用于识别显著变量。多变量逻辑回归用于解决混杂问题。
结果：确认了100名患者。89人符合纳入标准。平均随访34个月（中位数33）。7名患者（7.9％）发生FBS。Palatine肿瘤原发性（P=0.041），根瘤/咽喉切除术（P=.039），咽旁脂肪操纵（P=0.015）与FBS的存在有关。调整肿瘤位置后，咽旁脂肪的操作保持显著性(P=.025)。T和N分期，肿瘤体积,辅助辐射,舌/面动脉结扎与FBS的发生无关。86％（6/7）的患者平均11.3个月的FBS消退。
结论：在我们的队列中，咽旁间隙的操纵与TOS中FBS的发展独立相关。需要进一步的验证性研究。
方法：回顾性图表回顾。
方法：三级医疗中心。
方法：这项研究被梅奥诊所机构审查委员会豁免。我们从2017年1月至2022年11月对所有接受OPSCCTOS的患者进行了审查。排除标准包括少于6个月的随访，头颈癌的先前治疗，或不完整的记录。人口统计数据,合并症,肿瘤特征，手术细节,辅助治疗细节，功能结果，并评估肿瘤结局.Fisher精确检验和Kruskal-Wallis秩和检验用于识别显著变量。多变量逻辑回归用于解决混杂问题。
结果：确认了100名患者。89人符合纳入标准。平均随访34个月（中位数33）。7名患者（7.9％）发生FBS。Palatine肿瘤原发性（P=0.041），根瘤/咽喉切除术（P=.039），咽旁脂肪操纵（P=0.015）与FBS的存在有关。调整肿瘤位置后，咽旁脂肪的操作保持显著性(P=.025)。T和N分期，肿瘤体积,辅助辐射,舌/面动脉结扎与FBS的发生无关。86％（6/7）的患者平均11.3个月的FBS消退。
结论：在我们的队列中，咽旁间隙的操纵与TOS中FBS的发展独立相关。需要进一步的验证性研究。
