2017
DOI: 10.1007/s00405-017-4521-z
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Trigeminocardiac reflex during endoscopic juvenile nasopharyngeal angiofibroma surgery: an appraisal

Abstract: Juvenile nasopharyngeal angiofibroma is a locally aggressive benign tumour which has propensity to erode the skull base. The tumour spreads along the pathways of least resistance and is in close proximity to the extracranial part of trigeminal nerve. Advancements in expanded approaches for endoscopic excision of tumours in infratemporal fossa and pterygopalatine fossa increase the vulnerability for the trigeminocardiac reflex. The manipulation of nerve and its branches during tumour dissection can lead to sens… Show more

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Cited by 7 publications
(5 citation statements)
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“…Several suggestions have been proposed to help reduce the risk of TCR occurring during surgery, for example, avoiding light anaesthsia, being cautions of beta blockers and calcium channel blocker use and providing adequate pain management peri-operatively for patients undergoing nasal surgery. [ 3 , 13 ] In addition, the administration of NMDA receptor antagonist during induction of general anaesthsia was reported to decrease the risk of oculo-cardiac reflex during strabismus surgery. [ 14 ]…”
Section: Discussionmentioning
confidence: 99%
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“…Several suggestions have been proposed to help reduce the risk of TCR occurring during surgery, for example, avoiding light anaesthsia, being cautions of beta blockers and calcium channel blocker use and providing adequate pain management peri-operatively for patients undergoing nasal surgery. [ 3 , 13 ] In addition, the administration of NMDA receptor antagonist during induction of general anaesthsia was reported to decrease the risk of oculo-cardiac reflex during strabismus surgery. [ 14 ]…”
Section: Discussionmentioning
confidence: 99%
“…[2] The incidence of TCR among endoscopic nasal surgery was reported to be 4.15% but TCR induced cardiac arrest (CA) was very rare. [3] Herein, we report a case of CA induced by TCR not responding to standard resuscitation protocol. The patient was successfully resuscitated after a period of support with veno-arterial extracorporal membrane oxygenation (VA-ECMO).…”
Section: Introductionmentioning
confidence: 98%
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“…In case of endoscopic surgery involving any part of the trigeminal nerve, adequate briefing with the anesthesiologist is also mandatory. In fact, trigeminal stimulation might suddenly provoke dysrhythmia, hypotension, or even asystole due to the trigemino-cardiac reflex 99,100 . Management of the trigemino-cardiac reflex is mainly based on preoperative risk evaluation, vigilance during anesthesia, effective communication for a rapid cessation of precipitating stimuli, and prompt correction of cardiovascular changes.…”
Section: Intraoperative Complications Requiring Multidisciplinary Managementmentioning
confidence: 99%
“…11 2'2021 Клинический случай доступов к подвисочной и крыловидно-небной ямкам хирургические манипуляции при удалении ангиофибромы могут вызвать раздражение ветвей тройничного нерва и так называемый тригеминокардиальный рефлекс. Появление данного рефлекса во время операции представляет риск для жизни больного [16]. Попадание воздуха в подкожно-жировую клетчатку и средостение при эндоскопических операциях на околоносовых пазухах встречается редко.…”
Section: Introductionunclassified