Gustatory parotid pain

Abstract

We report the case of a 42-year-old woman with gustatory parotid pain. Considering the presence of unilateral Horner and Harlequin syndrome, it was possible that the underlying condition was unilateral cervical sympathetic neuropathy. The patient experienced sharp pain in the region of the parotid gland on the cervical sympathetic neuropathy side immediately after gustatory stimulation using food, immediately followed by a spontaneous remission. Gustatory sweating was noted in the same area. Gustatory parotid pain was caused by denervation hypersensitivity of the sympathetic and parasympathetic receptors of the parotid gland due to cervical sympathetic neuropathy. It is possible that this phenomenon could be etiologically associated with increased pressure in the ducts and induced pain due to increased reflex salivary secretion via gustatory stimulation and strong contraction of myoepithelial cells. MRI revealed no abnormalities in the brain, neck, or chest, and the cause of sympathetic neuropathy remained unknown. Gustatory parotid pain has been reported as the first bite syndrome in the field of otolaryngology. This phenomenon was misquoted in a paper by Haubrich et al. (1986) and should be called “gustatory parotid pain” according to the first paper on this phenomenon by Gardner et al. (1955).