Sinus Bradycardia and Hypotension Following Reconstructive Hemi Mandibulectomy. Unusual Complication of Orofacial Reconstructive Surgery

Abstract

Postoperative complications following pectoralis major myocutaneous flap in orofacial reconstruction are a well-known entity. Still, literature search didn’t reveal sinus bradycardia as one of those post-operative complications. One of our patients, a 63-year-old gentleman with squamous cell carcinoma in the right cheek, who underwent wide local excision with right side hemimandibulectomy and pectoralis major myocutaneous flap reconstruction, developed symptomatic sinus bradycardia and hypotension as a postoperative complication. Initially there was a struggle to find out the underlying cause but later, carotid sinus hypersensitivity was suspected as a probable cause. Ultimately, it was alleviated by a debulking surgery to reduce the pressure in the neck.