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Journal of Korean Neurosurgical Society > Volume 42(1); 2007 > Article
Journal of Korean Neurosurgical Society 2007;42(1): 16-19.
Lateral Third Infraclavicular Implantation of the Vagal Nerve Stimulation Generator Through Axillary Incision.
Young Jae Lee, Jae Woo Kim, Ik Soo Kim, Myung Ki Lee, Chang Ghue Ghang, Young Woo Lee
Department of Neurosurgery, Bong Seng Memorial Hospital, Busan, Korea. drghang@chol.com
This report describes the clinical study of the surgical method of lateral third infraclavicular implantation of vagal nerve stimulation (VNS) generator through the axillary wrinkle incision.
In a retrospective study, the data for 20 patients with medically intractable epilepsy treated by this approach were examined. The mean age was 31.4 years (range : 14-50), and the mean follow-up period was 12.15 months (range : 4-21 months). The male to female ratio was 2.3 : 1. The subcutaneous pocket for the generator was located in the lateral third infraclavicular area through the axillary wrinkle. Our method was a modification of the standard VNS generator implantation in the mid-infraclavicular pocket through anterior axillary incision.
There were the excellent or good cosmetic satisfaction in 95% of the cases and fair in 5%. The generator was located outside the lung field in 15%, periphery of the lung field in 45%, and crossed over the lung field in 40%. Discomfort from shoulder motion occurred transiently in 35% of cases. Other complications were minimal.
These results demonstrate that the lateral third infraclavicular apporach will offers cosmetic benefits and reduction of obscuration of the lung field without serious complications. Thus, this technique provides an attractive alternative among the surgical techniques for the vagal nerve stimulation.
Key Words: Vagal nerve stimulation; Infraclavicular approach; Lateral
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