gms | German Medical Science

73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Postoperative dysphagia after vagus nerve stimulation

Postoperative Dysphagie nach Vagusnerv Stimulation

Meeting Abstract

  • presenting/speaker Johanna Quick-Weller - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt a. M., Deutschland
  • Nikhil Thakur - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt a. M., Deutschland
  • Elena Harborth - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt a. M., Deutschland
  • Christiane Nasari - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt a. M., Deutschland
  • Lena Stange - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt a. M., Deutschland
  • Marcus Czabanka - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt a. M., Deutschland
  • Sriramya Lapa - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt a. M., Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV160

doi: 10.3205/22dgnc158, urn:nbn:de:0183-22dgnc1580

Published: May 25, 2022

© 2022 Quick-Weller et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Vagus Nerve Stimulation (VNS) has been used to alleviate a variety of intractable conditions including therapy-refractory epilepsy and depression. The vagus innervates a relevant portion of the musculature involved in speech-production and deglutition. Dysphagia and dysphonia in relation to VNS – the surgical implantation of the device and the subsequent stimulation itself, have not been conclusively investigated.

Methods: VNS implantation procedures were carried out for a total of 16 patients at our neurosurgical unit between September 2019 and March 2021. A postoperative fiber endoscopic evaluation of swallowing (FEES) was conducted for all patients. The severity of dysphagia and impairment of oral intake, graded on the functional oral intake scale (FOIS) were recorded. Patients with a concomitant condition causing dysphagia were excluded from the analysis.

Results: 14 patients (43.75% females, median age 49±19 years) suffering from therapy-refractory epilepsy (3 = 21.42%)) or depression (11 = 78.57%) were included in the analysis. Two patients were excluded due to a concomitant cause for dysphagia. Among the patients included in the analysis, 10 (71.43%) were found to have dysphagia. Hypopharyngeal residues were the major finding. 7 patients (50%) had a mild and 2 (14.29%) a moderate dysphagia. None of the patients were found to have severe dysphagia. The remaining 5 patients (35.71%) were found to have normal deglutition. FOIS 5 and FOIS 7 recommendations for oral intake were required in 5 patients each. 5 patients were diagnosed with a left sided vagal paresis without a correlation with their severity of dysphagia.

Conclusion: The results suggest that VNS implantation and/or the subsequent stimulation can lead to dysphagia. Currently, we can recommend postoperative assessment of deglutition. The strongest limitation of this study design was a purely postoperative diagnostic scheme. A further investigation with preoperative screening is planned in a prospective setting. Furthermore, additional studies with a larger number of subjects are needed to assess, among other parameters, spontaneous restitution at long term follow up.