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59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

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Operative and technical complications of vagus nerve stimulator implantation

Operative und technische Komplikationen der Vagusnerv-Stimulation

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  • corresponding author S. Spuck - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
  • G. Nowak - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
  • A. Sepehrnia - Klinik für Neurochirurgie, Clemenshospital, Münster
  • R. Schönweiler - Klinik für Phoniatrie und Pädaudiologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
  • J. Sperner - Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
  • V. Tronnier - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMO.04.10

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc066.shtml

Published: May 30, 2008

© 2008 Spuck et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: In this study the incidence of surgical and technical complications after implantation of left sided vagus nerve stimulation (VNS) in patients with therapy refractory epilepsy was analyzed.

Methods: 87 patients receiving a VNS from 1999 to 2006 were retrospectively investigated.

Results: 73 patients were younger than 18 years (83.9%) with a mean age of 13.8 years. The stimulator was changed in eleven patients. Of the 87 patients treated thirteen (14.9%) had complications, in five patients (5.7%) caused by the operation. The device was removed in five patients. Complications were deep wound infections after implantation, secondary generator infection 3 years after implantation, transient palsy of the vocal cord, cardiac arrhythmia under test stimulation, lead fracture and posttraumatic dysfunction of the stimulator. One patient died. In one case the device was explanted due to lack of efficiency and stimulation dependent side effects with hoarseness, torticollis and sleep disorders.

Conclusions: Surgically induced complications of VNS implantation are rare. Especially, posttraumatic generator malfunction, cardiac symptoms and recurrent nerve palsy have to be taken into consideration. It seems that older patients get are more likely to be affected by recurrent nerve than younger patients. The operative replacement of helical electrodes in children is possible but technical fastidious.