The Trigeminocardiac Reflex during the Anterior Transpetrosal Approach

Shunsuke Shibao; Karam Kenawy; Hamid Borghei-Razavi; Kazunari Yoshida

doi:10.1055/s-0038-1633663

Journal of Neurological Surgery Part B: Skull Base, Inhaltsverzeichnis

J Neurol Surg B Skull Base 2018; 79(S 01): S1-S188
DOI: 10.1055/s-0038-1633663

Poster Presentations

Georg Thieme Verlag KG Stuttgart · New York

The Trigeminocardiac Reflex during the Anterior Transpetrosal Approach

Shunsuke Shibao

¹Department of Neurosurgery, Ashikaga Red Cross Hospital, Ashikaga, Yobecho, Japan

,

Karam Kenawy

²Department of Neurosurgery, Sohag University, Sohag, Egypt

,

Hamid Borghei-Razavi

³Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States

,

Kazunari Yoshida

⁴Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan

› Institutsangaben

Abstract

Volltext

Background The anterior transpetrosal approach (ATPA), during which the trigeminal nerve is manipulated, has a risk of eliciting the trigeminocardiac reflex (TCR). The objective of this study was to assess the risk of the TCR during the ATPA.

Methods The surgical records of 92 patients who had surgical treatment via the ATPA at the Keio University Hospital between December 2005 and June 2015 were retrospectively analyzed. They were divided into two groups on the basis of the occurrence of the TCR during surgery, and their clinical and tumor characteristics were compared. Tumor characteristics were evaluated based on preoperative images and intraoperative findings and included the side of the lesion, size of the lesion, tumor size in the Meckel’s cave, pathology of the disease, cavernous sinus invasion, extension into the Meckel’s cave, and adhesion of the lesion to the trigeminal nerve.

Results TCR was observed in 14 of the 92 patients (15.2%). TCR occurrence was significantly related to the size of the tumor in Meckel’s cave (p = 0.0264) and adhesion of the lesion to the trigeminal nerve (p = 0.0002).

Conclusion This suggests that TCR is related to Meckel’s cave tumor size and tumor adhesion to the trigeminal nerve in the ATPA. To our knowledge, this is the first report describing TCR during the ATPA.