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Treatment of epilepsy by stimulation of the vagus nerve from Head‐and‐Neck surgical point of view
Author(s) -
Lotan Gad,
Vaiman Michael
Publication year - 2015
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25064
Subject(s) - medicine , vagus nerve , surgery , vagus nerve stimulation , complication , epilepsy , head and neck , sternocleidomastoid muscle , anesthesia , stimulation , psychiatry
Objectives/Hypothesis The current article is dedicated to the surgical aspect of the vagus nerve stimulation (VNS) and our efforts to improve the surgical technique. The aim was to reduce the side effect/surgical complication rate as well as the time needed for this surgery. Study Design A case series. Methods The surgical data of 72 consecutive patients (age 4–14) who were operated for VNS device implantation from 2007 to 2014 were collected and analyzed. We designed the new surgical protocol that was implemented in all 72 cases and analyzed postsurgical side effects/complication rates. This protocol suggests low neck incision, detecting the vagus between the heads of the sternocleidomastoid muscle, a submuscular pocket for the device, and a short tunnel between it and the vagus electrodes. Results The implantation took about 40 minutes; 4.2% of the patients (n = 3) were afflicted by complications related to surgery; and one patient (1.4%) suffered from hardware malfunctions. Side effects related to VNS therapy itself occurred in seven cases (6.9%). Conclusion To minimize laryngeal complications in implantation surgery for VNS devices, the surgical technique should be significantly modified, and lower neck incision could be implemented together with a submuscular pocket for the battery. Level of Evidence 4. Laryngoscope , 125:1352–1355, 2015