title: A profound case of neurally mediated syncope with asystole after septoplasty.
abstract: Vasovagal syncope (VVS) is an alarming yet benign condition that may present postoperatively for the first time in otherwise healthy patients. Although VVS is associated anecdotally with nasal manipulation, no data have been found to quantify this incidence with otolaryngology surgeries. We present a case of profound, recurrent syncope and documented asystole with an initial diagnosis of glossopharyngeal neuralgia. We conclude with a discussion of neurally mediated syncope particular to the perioperative setting. It is essential to recognize neurocardiogenic etiology to differentiate it from other more concerning causes of syncope and asystole.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Tripler Army Medical Center, TAMC, HI 96859, USA. douglas.ruhl@amedd.army.mil
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Ruhl
authors.forename: Mitchell J
authors.initials: MJ
authors.lastname: Ramsey
authors.forename: David M
authors.initials: DM
authors.lastname: Ruffin
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D020435:Glossopharyngeal Nerve Diseases / Q000175:diagnosis; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D008297:Male; D009300:Nasal Septum / Q000601:surgery*; D012008:Recurrence; D012225:Rhinoplasty / Q000009:adverse effects*; D019462:Syncope, Vasovagal / Q000175:diagnosis / Q000209:etiology*