Although most patients who experience the trigeminocardiac reflex (TCR) have an uneventful follow-up, a careful analysis reveals that the TCR may lead to relevant functional consequences. This chapter points out the potential impact of the TCR on patients’ outcomes.
There is a clear correlation between occurrences of the TCR and the postoperative risk of hearing loss in vestibular schwannoma surgery, particularly with large tumors. Regarding pathophysiological mechanisms, an already compromised vascular supply to the nerve and the cochlea due to tumor compression will become worse if a sudden intraoperative hypotension occurs along with the TCR. In large vestibular schwannomas, this phenomenon may be even more evident. The incidence of postoperative tinnitus is increased in patients with vestibular schwannomas who exhibit the TCR during the tumor resection.
There also appears to be a correlation between hearing loss and the appearance of the TCR in nonvestibular schwannoma surgery of cerebellopontine angle tumors. However, further studies are necessary to confirm this hypothesis. Arrhythmias resulting from trauma may be persistent as long as some stimulus on the trigeminal nerve ramifications is maintained. Perioperative physicians should be aware of this possibility, as well as of the risk of death resulting from cardiac arrest following facial injury.
Although most cases of the TCR that develop during surgery have a benign course, the presence of a cardiac disease may increase the risk of fatal complications.
