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Operative and Technical Complications of Vagus Nerve Stimulator Implantation

机译：迷走神经刺激器植入的手术和技术并发症

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摘要

The treatment of refractory epilepsy by vagus nerve stimulation (VNS) is a well-established therapy option for patients not suitable for epilepsy surgery and therapy refractory depressions.OBJECTIVE: To analyze surgical and technical complications after implantation of left-sided VNS in patients with therapy-refractory epilepsy and depression. METHODS: One hundred five patients receiving a VNS or VNS-related operations (n = 118) from 1999 to 2008 were investigated retrospectively. RESULTS: At the time of operation, 84 patients were younger than 18 years, with a mean age of 10.5 years. Twenty (19%) patients had technical problems or complications. In 6 (5.7%) patients these problems were caused by the operation. The device was removed in 8 cases. The range of surgically and technically induced complications included electrode fractures, early and late onset of deep wound infections, transient vocal cord palsy, cardiac arrhythmia under test stimulation, electrode malfunction, and post-traumatic dysfunction of the stimulator.CONCLUSION: VNS therapy is combined with a wide spread of possible complications. Technical problems are to be expected, including electrode fracture, dislocation, and generator malfunction. The major complication in younger patients is the electrode fracture, which might be induced by growth during adolescence. Surgically induced complications of VNS implantation are comparably low. Cardiac symptoms and recurrent nerve palsy need to be taken into consideration.
机译：迷走神经刺激（VNS）治疗难治性癫痫是针对不适合癫痫手术和难治性抑郁症患者的行之有效的治疗方法。目的：分析左侧VNS植入患者的手术和技术并发症-难治性癫痫和抑郁症。方法：回顾性分析1999年至2008年间接受VNS或VNS相关手术的105例患者（n = 118）。结果：手术时，年龄小于18岁的84例患者，平均年龄为10.5岁。二十名（19％）患者出现技术问题或并发症。在6名（5.7％）患者中，这些问题是由手术引起的。该设备在8个案例中被移除。手术和技术引起的并发症范围包括电极断裂，深部伤口感染的早期和晚期发作，短暂性声带麻痹，被测刺激下的心律不齐，电极故障以及刺激器的创伤后功能障碍。并可能引起各种并发症。预计会出现技术问题，包括电极断裂，错位和发生器故障。年轻患者的主要并发症是电极断裂，这可能是青春期生长引起的。 VNS植入手术引起的并发症相对较低。需要考虑心脏症状和神经麻痹。

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