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56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Subpectoral versus Subcutaneous Positioning of the Vagal Nerve Stimulation Device

Meeting Abstract

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  • corresponding author A. Rominger - Neurochirurgische Klinik, Neurozentrum, Universitätsklinikum Freiburg
  • J. R. Madsen - Department of Neurosurgery, Children's Hospital, Harvard Medical School, Boston/USA

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP018

The electronic version of this article is the complete one and can be found online at:

Published: May 4, 2005

© 2005 Rominger et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




Vagal nerve stimulation is a relatively novel treatment option for patients suffering from epilepsy where pharmacotherapy did not control seizures properly or resection was not feasible. There are several different styles described in the literature on how to insert the device. Here we report on a comparison of the subpectoral with the traditional subcutaneous placement.


We sent out questionnaires to 58 patients who got a VNS device at Children's Hospital, Boston, U.S.A. and a consecutive replacement of the generator between 1997 and 2003. In one half of the patients the device remained in the subcutaneous pocket (SC group), in the other half the generator was relocated to a deeper subpectoral pocket (SP group). We evaluated patients' acceptance and clinical outcome in both groups.


All patients survived the procedure and were discharged from hospital. There were no complications during surgery in any group. In the SC group first week's pain was in 10 patients less than after the first surgery, in the SP group in 5 patients pain was less. More pain was noted from 2 patients in the SC group and 4 patients in the SP group. After the second surgery, 18% of the SC group considered the result as better from a cosmetic point of view, whereas in the SP group 39 % preferred the result after the second procedure. Among the SP group 83% preferred much more the new location, 13% did not feel any difference and 4% preferred the old location.


Subpectoral insertion of the VNS device is a safe method with comparable complication rates to established techniques and furthermore very well accepted by patients. Patients who experienced both locations preferred the subpectoral citing.