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Bradycardia and asystole due to the trigeminocardiac reflex can occur during several maxillofacial, skull base and ophthalmic procedures.We describe a case where severe bradycardia occurred during superficial parotidectomy. The case report is presented to show a possible existence and importance of reflex bradycardic responses that may occur during surgical procedures involving the parotid gland and their management.

The aesthetic and functional role of the human face can not be overemphasized. It is keystone in perception of self-identity and represents the most striking features of an individual's being. Being a place of concentration of major perceptive organs, like eyes, ears and nose, the face also has direct involvement in emotional and social communication. Facial disfigurements may present in different forms, varying from minor nuisances to severe debilitating problems. The main goals in reconstruction of severely deformed face include restoration of function, comfort and appearance. Nowadays we have plenty of surgical modalities to fulfill these tasks, including cadaveric face transplantation. However, neither of the procedures can be considered as fully consistent in terms of achievable results. Here we describe reconstruction of face by expanded supraclavicular flap. Two clinical cases are presented. We performed a three-stage reconstruction, which included implantation of tissue expander in supraclavicular area, subsequent transfer of a fasciocutanous flap onto the face, and finally, pedicle division of the flap with additional scar revision. A satisfactory fascial shape has been achieved. We believe that supraclavicular flap, prefabricated by expansion is a powerful tool for autologous reconstruction of face and can be successfully used in selected cases.