Servello Domenico, Saleh Christian, Zekaj Edvin
Department of Neurosurgery, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Asian J Neurosurg. 2018 Oct-Dec;13(4):1252-1253. doi: 10.4103/ajns.AJNS_184_17.
Skin erosion and infection are common but serious problems in deep brain stimulation (DBS). They can lead to the removal of the entire DBS device and consequently stop the entire treatment. Of critical importance, therefore, is to find surgical solutions that allow to leave the complex DBS device in place when medical treatment fails in repeated skin complications, to allow continuing treatment in otherwise pharmacological refractory patients. We present a patient with repeated retro-auricular skin erosions, who failed to respond to surgical revisions and antibiotic treatment. However, instead of removing the DBS device as it would be general practice we succeeded with a right to left transposition of connecting cables to save the entire DBS system. There is lack of data on therapeutic surgical options in repeated skin complications. We propose the transposition of DBS device as possible solution for multiple skin erosions in DBS surgery.
皮肤糜烂和感染是深部脑刺激（DBS）中常见但严重的问题。它们可能导致整个DBS装置被移除，从而使整个治疗中断。因此，至关重要的是找到手术解决方案，以便在反复出现皮肤并发症且药物治疗无效时，能够保留复杂的DBS装置，从而使原本药物难治的患者能够继续接受治疗。我们报告了一名反复出现耳后皮肤糜烂的患者，该患者对手术修复和抗生素治疗均无反应。然而，我们没有像通常那样移除DBS装置，而是成功地将连接电缆从右侧移至左侧，从而挽救了整个DBS系统。目前缺乏关于反复出现皮肤并发症时治疗性手术选择的数据。我们建议将DBS装置移位作为DBS手术中多次皮肤糜烂的一种可能解决方案。
