Department of Functional and Stereotactic Neurosurgery, Timone University Hospital, Aix Marseille University, Marseille, France.
APHM, INSERM, INS, Inst Neurosci Syst, Aix Marseille University, Marseille, France.
Acta Neurochir (Wien). 2020 Oct;162(10):2509-2512. doi: 10.1007/s00701-020-04535-y. Epub 2020 Aug 18.
For the vast majority of surgeons, no specific investigation is necessary before vagal nerve stimulation (VNS) implantation. We report our intraoperative unexpected finding of a massively enlarged vagus nerve in a patient with neurofibromatosis type 1 (NF1). The nerve hypertrophy prevented wrapping the coils of the helical electrode. The patient had no signs of vagus nerve dysfunction preoperatively (no hoarseness or dysphonia). This exceptional mishap is undoubtedly related to NF1-associated peripheral nerve sheath tumors. Even though it is not advisable to routinely perform any imaging prior to VNS, in such specific context, preoperative imaging work-up, especially cervical ultrasound, might be judicious to rule out any asymptomatic enlarged left vagus nerve.
对于绝大多数外科医生来说，在进行迷走神经刺激（VNS）植入术前，无需进行特定的检查。我们报告了一例神经纤维瘤病 1 型（NF1）患者术中意外发现迷走神经明显增大的情况。由于神经肥大，无法缠绕螺旋电极的线圈。该患者术前没有迷走神经功能障碍的迹象（无声音嘶哑或发音困难）。这种特殊的并发症无疑与 NF1 相关的外周神经鞘肿瘤有关。尽管在进行 VNS 术前不建议常规进行任何影像学检查，但在这种特殊情况下，术前影像学检查，特别是颈超声检查，可能有助于排除任何无症状的左侧迷走神经增大。
