Neurosurgery. 2010 Dec;67 Operative Neurosurgery, 2:ons457-ons460.
Revision of Vagal Nerve Stimulator Electrodes Through a Posterior Cervical Triangle Approach: Technical Note.
1Division of Pediatric Neurosurgery, The Children's Hospital, University of Colorado, Aurora, Colorado 2Department of Neurosurgery, Allegheny General Hospital, Drexel University School of Medicine, Pittsburgh, Pennsylvania.
Abstract
CLINICAL PRESENTATION:: Skin incision from the implantation surgery is incorporated and extended to allow access to the posterior border of the sternocleidomastoid muscle (SCM). Dissection proceeds along the posterior border of the SCM. The SCM and jugular vein are retracted anterior to expose a fresh segment of the vagal nerve immediately superficial to the carotid artery and proximal to the original electrode site. Once the nerve is adequately exposed, electrode placement proceeds in the standard fashion. Dysfunctional electrodes are left in place, and the lead wire is cut as near the electrodes as can be easily accessed. Three patients have undergone lead revision with this approach. Lead placement was successful and free from complications in all cases.
CONCLUSION:: The posterior cervical triangle approach provides a virgin dissection plane for VNS revision.
PMID: 21099572 [PubMed - as supplied by publisher
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