Ortler Martin, Unterhofer Claudia, Dobesberger Judith, Haberlandt Edda, Trinka Eugen
Clinical Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria.
J Neurosurg Pediatr. 2010 Feb;5(2):191-4. doi: 10.3171/2009.9.PEDS0810.
Vagus nerve stimulation has become widely used in the palliative treatment of refractory epilepsy. Removal of a vagus nerve stimulator may be desirable or even necessary due to lack of efficacy, intolerable side effects, signs of infection, or failure of the device. Unless the lead or the helical electrodes are defective, only the generator is explanted and the electrodes are usually left behind for fear of damaging nerve or surrounding structures. The authors review their experience with complete removal of the stimulating electrodes and pacemaker-like generator device in 9 consecutive patients, 3 of whom were children. Using microsurgical techniques, the authors were able to completely remove the stimulator, including electrodes in all patients. All nerves remained morphologically intact. One case of temporary and one of permanent clinically silent ipsilateral vocal cord paresis were observed.
迷走神经刺激已广泛应用于难治性癫痫的姑息治疗。由于缺乏疗效、出现无法耐受的副作用、感染迹象或设备故障，移除迷走神经刺激器可能是可取的，甚至是必要的。除非导线或螺旋电极有缺陷，通常仅取出发生器，而保留电极，以免损伤神经或周围结构。作者回顾了他们连续9例患者（其中3例为儿童）完全移除刺激电极和起搏器样发生器装置的经验。作者采用显微外科技术，成功地在所有患者中完全移除了刺激器，包括电极。所有神经在形态上均保持完整。观察到1例出现暂时性、1例出现永久性同侧声带麻痹且无临床症状。
