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

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 hemi-mandibulectomy 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.