Türk Nöroşirürji Dergisi 2021 , Vol 31 , Num 3
Vagal Nerve Stimulation: Surgical Technique and Complications
Ahmet Cemil ERGÜN1,Selman KÖK1,Sait ÖZTÜRK1
1Fırat Üniversitesi Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Elâzığ, Türkiye Vagal nerve stimulation (VNS) is an important neuromodulative surgical treatment option used especially in the treatment of drugresistant epilepsy patients and also in the treatment of drug-resistant depression. Typically, VNS should be used in the management of seizures in patients who do not respond effectively to resective surgery, who are unsuitable for resection, or who refuse resective surgery. The VNS system consists of an electrode and a pulse generator. With the microsurgical technique, the electrode is implanted in the cervical middle part of the left vagal nerve in the neck region. The VNS electrode is targeted for implantation by prioritizing the left vagal nerve to avoid stimulation-induced bradycardia or asystole. Then, electrode integration is provided to a generator (battery) usually placed in the chest area. The primary goal is to reduce the number, frequency and duration of seizures. Complications include those in the intraoperative period (vocal cord damage, neurovascular damage, hematoma formation) or postoperative period (infection), stimulation-related (hoarseness, cough, hoarseness, arrhythmia) complications, and hardwarerelated complications (electrode fracture, migration, deactivation of the generator). Anahtar Kelimeler : Vagal nerve stimulation, Epilepsy, Surgical technique, Complication