• Mee Young Chung, Min Jung Shin, Seung Hee Cha, and Ji Yung Lee.
• Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
• Medicine (Baltimore). 2022 Nov 4; 101 (44): e31720e31720.

RationaleNeurally mediated reflexes can induce cardiac arrest during head and neck surgery through mechanisms including direct vagal stimulation, trigeminocardiac reflex, and baroreceptor reflex. Balloon dilation of the Eustachian tube (BDET) is a safe procedure without serious complications, including cardiac arrest.Patient ConcernsTransient asystole developed during BDET under general anesthesia in a 33-year-old woman as soon as the balloon in the Eustachian tube (ET) was inflated.DiagnosesMonitoring records were reviewed. The asystolic period was recorded on the patient monitor as an event, which we recalled and printed. The asystole lasted for 13 seconds.InterventionsThe patient recovered sinus rhythm spontaneously after the balloon was deflated before resuscitation. The BDET was successfully performed after prophylaxis with vagolytic drugs.OutcomesThe patient recovered uneventfully after anesthesia.LessonsBDET, previously known to be a relatively safe procedure, induces asystole via balloon dilation. It is thought to be a neurally mediated vagal reflex, and both anesthesiologists and otologic physicians should pay proper attention to monitoring during the procedure.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

16 keywords...

hide…