Yazama Hiroaki, Hasegawa Kensaku, Kurosaki Masamichi, Kunimoto Yasuomi, Watanabe Tasuku, Fujiwara Kazunori, Takeuchi Hiromi
Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan.
Nippon Medical School Chiba Hokusoh Hospital, Inzai 270-1694, Japan.
Yonago Acta Med. 2020 Nov 24;63(4):376-378. doi: 10.33160/yam.2020.11.015. eCollection 2020 Nov.
A 75-year-old female patient presented with a suspected recurrence of a clival chordoma. The tumor was resected using the infratemporal fossa type B and anterior petrosal approach with the help of a neurosurgeon. During cauterization of the trigeminal nerve, the patient developed cardiac arrest for approximately 10 seconds because of the trigemino-cardiac reflex (TCR). After several sternal compressions, there was return of spontaneous circulation. The operation was resumed after the circulatory dynamics stabilized. Subsequently, the surgery was completed with partial resection of the tumor without the recurrence of cardiac arrest. The pathological diagnosis was chondrosarcoma, and postoperative treatment with radiotherapy was started. Stimulation of the sensory branches of the trigeminal nerve induces TCR. There are reports of TCR developing in approximately 10% of skull base surgery cases in the absence of atropine administration. We report a rare case of TCR during the surgical procedure for the treatment of a skull base chondrosarcoma.
一名75岁女性患者被怀疑斜坡脊索瘤复发。在神经外科医生的帮助下，采用颞下窝B型和岩前入路切除肿瘤。在烧灼三叉神经时，患者因三叉神经-心脏反射（TCR）发生心脏骤停约10秒。经过几次胸外按压后，恢复了自主循环。循环动力学稳定后手术继续进行。随后，手术完成，肿瘤部分切除，未再次发生心脏骤停。病理诊断为软骨肉瘤，并开始进行术后放疗。刺激三叉神经的感觉支可诱发TCR。有报道称，在未使用阿托品的情况下，约10%的颅底手术病例会发生TCR。我们报告了一例在治疗颅底软骨肉瘤手术过程中发生TCR的罕见病例。
