Department of Neurosurgery, Eberhard Karls University Hospital, Hoppe-Seyler Strasse 3, D-72076 Tübingen, Germany.
J Clin Neurosci. 2011 Feb;18(2):237-40. doi: 10.1016/j.jocn.2010.03.063. Epub 2010 Dec 15.
The trigeminocardiac reflex (TCR) is a common event during skull base surgery that can lead to intraoperative arterial hypotension and bradycardia. Arterial hypotension associated with TCR can be a negative prognostic factor for postoperative auditory function and ipsilateral tinnitus in patients undergoing surgery for vestibular schwannoma (VS). In this study, the contribution of TCR to postoperative auditory function in non-VS cerebellopontine angle (CPA) tumor surgery was investigated. From a consecutive series of 102 patients with CPA tumors, we studied the occurrence of TCR and its influence on postoperative auditory function in patients with non-VS tumors. Pre- and postoperative auditory function, pre- and intraoperative mean arterial blood pressure, as well as preoperative medication, tumor size, and occurrence of TCR were evaluated. Of the 35 patients evaluated, four developed intraoperative TCR, of whom one was preoperatively deaf. Preoperative functional hearing was detected in 30/35 patients (85.7%): preoperative deafness was documented in one patient in the TCR group and in four patients in the non-TCR group. Of the 30 patients with preoperative functional hearing, 1/3 (33.3%) patients in the TCR group and 23/27 (85.2%) patients in the non-TCR group had functional hearing postoperatively. When patients with large tumors and functional, hearing were considered, only 33.3% of patients in the TCR group and 77.8% of patients in the non-TCR group remained within the same hearing classes following surgical treatment (p=0.1573). TCR may be a negative prognostic factor for postoperative auditory function in patients with large, non-VS CPA tumors.
三叉心动反射（TCR）是颅底手术中常见的事件，可导致术中动脉低血压和心动过缓。与 TCR 相关的动脉低血压可能是前庭神经鞘瘤（VS）患者手术后听觉功能和同侧耳鸣的负面预后因素。在这项研究中，研究了 TCR 对非 VS 桥小脑角（CPA）肿瘤手术术后听觉功能的影响。我们从连续的 102 例 CPA 肿瘤患者中，研究了非 VS 肿瘤患者中 TCR 的发生及其对术后听觉功能的影响。评估了术前和术后听觉功能、术前和术中平均动脉血压以及术前用药、肿瘤大小和 TCR 的发生情况。在评估的 35 例患者中，有 4 例发生术中 TCR，其中 1 例术前失聪。35 例患者中有 30 例（85.7%）术前有功能性听力：TCR 组的 1 例患者和非 TCR 组的 4 例患者术前失聪。在术前有功能性听力的 30 例患者中，TCR 组中有 1/3（33.3%）患者和非 TCR 组中有 23/27（85.2%）患者术后有功能性听力。当考虑到大型肿瘤和功能性听力的患者时，TCR 组只有 33.3%的患者和非 TCR 组 77.8%的患者在手术治疗后仍处于相同的听力水平（p=0.1573）。TCR 可能是大型非 VS CPA 肿瘤患者术后听觉功能的负面预后因素。
