gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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The impact of hypotension due to the trigeminocardiac reflex on auditory function in vestibular schwannoma surgery

Der Einfluss von Hypotension infolge des trigeminocardialen Reflexes auf die Hörfunktion nach Vestibularis-Schwannom-Operationen

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  • corresponding author A. Gharabaghi - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • A. Körbel - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • A. Samii - Klinik für Neurochirurgie, International Neuroscience Institute, Hannover
  • J. Kaminsky - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • M. Tatagiba - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • M. Samii - Klinik für Neurochirurgie, International Neuroscience Institute, Hannover

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP197

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0465.shtml

Published: May 4, 2005

© 2005 Gharabaghi et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

Surgical manipulation of the fifth cranial nerve during its intra- or extracranial course may lead to patient’s bradycardia or even asystolia along with arterial hypotension, a phenomenon described as the trigeminocardiac reflex (TCR). We study the impact of this reflex on postoperative auditory function in vestibular schwannoma surgery.

Methods

One hundred subsequent patients scheduled for vestibular schwannoma surgery were studied prospectively for parameters influencing the postoperative auditory function. The evaluation included gender, age, pre- and postoperative auditory function, preoperative mean arterial blood pressure, preoperative medical diseases or medication (e.g. antiarrhythmic drugs), tumor size and localization, and the intraoperative occurrence of the TCR.

Results

The TCR, which occurred in 11% of the patients, influenced the postoperative hearing function in the patients with T3 and T4 vestibular schwannomas. With an overall hearing preservation of 47%, 11.1% of the TCR group and 51.4% of the non-TCR group showed preserved hearing function, postoperatively. In larger tumors (T3 and T4), patients with an intraoperative TCR had a significantly worse postoperative hearing function than those without a TCR during vestibular schwannoma surgery (p=0.005).

Conclusions

The hypotension following TCR is a negative prognostic factor for hearing preservation in vestibular schwannoma surgery. Referring to this knowledge patients’ information can be increased pre- and postoperatively. Further study of this phenomenon will advance the understanding of the underlying mechanisms and may help to improve hearing preservation by controlling the occurrence of the TCR.