SynthesisMedicina oral, patologia oral y cirugia bucal2025
Trigeminocardiac reflex in bimaxillary orthognathic surgery: case review.
Synthesis in Medicina oral, patologia oral y cirugia bucal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Recurrent Bronchospasm During Intra-arterial Chemotherapy via IMAX Access for Retinoblastoma: A Case Report.Cureus · 2026Article
- Ventricular Asystole During Le Fort I Orthognathic Surgery: A Case Consistent with Trigeminocardiac Reflex and a Mini Review.Clinics and practice · 2026Article
- Article
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8 authors.
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Abstract
backgroundThe trigeminocardiac reflex (TCR) is a rare but clinically significant phenomenon characterized by bradycardia, hypotension, or asystole triggered by trigeminal nerve stimulation during maxillofacial surgery. It necessitates prompt recognition and management to ensure patient safety. TCR has been reported in orthognathic surgery, particularly during specific surgical maneuvers. MATERIAL AND
methodsWe report the case of a 36-year-old male who experienced TCR during bimaxillary orthognathic surgery. Detailed documentation of the patient's clinical characteristics, intraoperative events, and management strategies was included. Additionally, we conducted a systematic review of the literature using Medline, Embase, Web of Science, and Scopus databases to identify cases of TCR in orthognathic surgery published from 1989 onward. Keywords included "trigeminocardiac reflex," "orthognathic surgery," "Le Fort I," and "bilateral sagittal split osteotomy".
resultsWe present the case of a patient who experienced transient bradycardia and asystole during mandibular manipulation and pterygomaxillary disjunction. The episode was successfully managed with atropine and cessation of triggering maneuvers. Additionally, a systematic review identified 10 cases of TCR in orthognathic surgery, most of which occurred during Le Fort I osteotomies, particularly during maxillary downfracture, followed by bilateral sagittal split osteotomies. Common manifestations included bradycardia and asystole. Management strategies involved cessation of surgical stimuli, administration of anticholinergic agents, and, in one severe case, cardiopulmonary resuscitation.
conclusionsTCR in orthognathic surgery is a significant risk requiring vigilance and prompt management. Understanding its triggers, maintaining intraoperative monitoring, and employing preventive strategies, such as gentle manipulation and proper anesthesia protocols, are essential for optimizing patient safety.
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