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Hamdi H, Spatola G, Lagarde S, McGonigal A, Paz-Paredes A, Bizeau A, Bartolomei F, Carron R. Use of Polyvinyl Alcohol Sponge Cubes for Vagal Nerve Stimulation: A Suggestion for the Wrapping Step. Technical Note and Step-by-Step Operative Technique. Oper Neurosurg (Hagerstown) 2021; 18:487-495. [PMID: 31386756 PMCID: PMC7594176 DOI: 10.1093/ons/opz227] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 05/29/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Vagal nerve stimulation (VNS) is an approved treatment for epilepsy and depression. Wrapping the helical electrodes around the nerve can prove technically challenging. However, a quick and efficient method to slightly elevate the nerve can highly facilitate this part of the procedure. OBJECTIVE To provide useful surgical tips to facilitate the procedure. METHODS Based on experience of more than 150 adult cases for mainly epilepsy (primary lead implant), the authors share their surgical technique to provide the experienced surgeons or newcomers to the field of VNS with some useful tips. All patients signed informed consent according to the local ethics committee guidelines. RESULTS The article consists of a detailed step-by-step description of the whole procedure illustrated through high-resolution colored photographs of the surgical field. Special reference is made to the usefulness of polyvinyl alcohol (PVA) sponge cubes to elevate the nerve instead of the commonly used silicon vessel loops. CONCLUSION The use of surgical microscope and PVA sponge cubes to elevate the nerve constitute key points to make VNS an easy surgery.
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Affiliation(s)
- Hussein Hamdi
- Department of Functional and Stereotactic Neurosurgery, Timone University Hospital, Marseille, France.,Aix Marseille Univ, APHM, INSERM, INS, Inst Neurosci Syst, Timone Hospital, Marseille, France.,Functional Neurosurgery and Stereotaxy Unit, Neurological Surgery Department, Tanta University, Egypt
| | - Giorgio Spatola
- Department of Functional and Stereotactic Neurosurgery, Timone University Hospital, Marseille, France.,Aix Marseille Univ, APHM, INSERM, INS, Inst Neurosci Syst, Timone Hospital, Marseille, France
| | - Stanislas Lagarde
- Epileptology Department, Aix Marseille Univ, APHM, INSERM, INS, Inst Neurosci Syst, Timone Hospital, Marseille, France
| | - Aileen McGonigal
- Epileptology Department, Aix Marseille Univ, APHM, INSERM, INS, Inst Neurosci Syst, Timone Hospital, Marseille, France
| | - Armando Paz-Paredes
- Department of Functional and Stereotactic Neurosurgery, Timone University Hospital, Marseille, France
| | - Alain Bizeau
- Department of Cervico-Facial Surgery, Sainte Musse Hospital, Toulon, France
| | - Fabrice Bartolomei
- Epileptology Department, Aix Marseille Univ, APHM, INSERM, INS, Inst Neurosci Syst, Timone Hospital, Marseille, France
| | - Romain Carron
- Department of Functional and Stereotactic Neurosurgery, Timone University Hospital, Marseille, France.,Aix Marseille Univ, APHM, INSERM, INS, Inst Neurosci Syst, Timone Hospital, Marseille, France
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Sterman J, Cunqueiro A, Dym RJ, Spektor M, Lipton ML, Revzin MV, Scheinfeld MH. Implantable Electronic Stimulation Devices from Head to Sacrum: Imaging Features and Functions. Radiographics 2019; 39:1056-1074. [DOI: 10.1148/rg.2019180088] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Jonathan Sterman
- From the Department of Radiology, Division of Emergency Radiology (J.S., A.C., M.L.L., M.H.S.), Department of Psychiatry and Behavioral Sciences (M.L.L.), and Dominick P. Purpura Department of Neuroscience (M.L.L.), Montefiore Medical Center, Albert Einstein College of Medicine, 111 E 210th St, Bronx, NY 10467; Department of Radiology, Rutgers New Jersey Medical School, Newark, NJ (R.J.D.); and Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Conn (M.S., M.V.R.)
| | - Alain Cunqueiro
- From the Department of Radiology, Division of Emergency Radiology (J.S., A.C., M.L.L., M.H.S.), Department of Psychiatry and Behavioral Sciences (M.L.L.), and Dominick P. Purpura Department of Neuroscience (M.L.L.), Montefiore Medical Center, Albert Einstein College of Medicine, 111 E 210th St, Bronx, NY 10467; Department of Radiology, Rutgers New Jersey Medical School, Newark, NJ (R.J.D.); and Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Conn (M.S., M.V.R.)
| | - R. Joshua Dym
- From the Department of Radiology, Division of Emergency Radiology (J.S., A.C., M.L.L., M.H.S.), Department of Psychiatry and Behavioral Sciences (M.L.L.), and Dominick P. Purpura Department of Neuroscience (M.L.L.), Montefiore Medical Center, Albert Einstein College of Medicine, 111 E 210th St, Bronx, NY 10467; Department of Radiology, Rutgers New Jersey Medical School, Newark, NJ (R.J.D.); and Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Conn (M.S., M.V.R.)
| | - Michael Spektor
- From the Department of Radiology, Division of Emergency Radiology (J.S., A.C., M.L.L., M.H.S.), Department of Psychiatry and Behavioral Sciences (M.L.L.), and Dominick P. Purpura Department of Neuroscience (M.L.L.), Montefiore Medical Center, Albert Einstein College of Medicine, 111 E 210th St, Bronx, NY 10467; Department of Radiology, Rutgers New Jersey Medical School, Newark, NJ (R.J.D.); and Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Conn (M.S., M.V.R.)
| | - Michael L. Lipton
- From the Department of Radiology, Division of Emergency Radiology (J.S., A.C., M.L.L., M.H.S.), Department of Psychiatry and Behavioral Sciences (M.L.L.), and Dominick P. Purpura Department of Neuroscience (M.L.L.), Montefiore Medical Center, Albert Einstein College of Medicine, 111 E 210th St, Bronx, NY 10467; Department of Radiology, Rutgers New Jersey Medical School, Newark, NJ (R.J.D.); and Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Conn (M.S., M.V.R.)
| | - Margarita V. Revzin
- From the Department of Radiology, Division of Emergency Radiology (J.S., A.C., M.L.L., M.H.S.), Department of Psychiatry and Behavioral Sciences (M.L.L.), and Dominick P. Purpura Department of Neuroscience (M.L.L.), Montefiore Medical Center, Albert Einstein College of Medicine, 111 E 210th St, Bronx, NY 10467; Department of Radiology, Rutgers New Jersey Medical School, Newark, NJ (R.J.D.); and Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Conn (M.S., M.V.R.)
| | - Meir H. Scheinfeld
- From the Department of Radiology, Division of Emergency Radiology (J.S., A.C., M.L.L., M.H.S.), Department of Psychiatry and Behavioral Sciences (M.L.L.), and Dominick P. Purpura Department of Neuroscience (M.L.L.), Montefiore Medical Center, Albert Einstein College of Medicine, 111 E 210th St, Bronx, NY 10467; Department of Radiology, Rutgers New Jersey Medical School, Newark, NJ (R.J.D.); and Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Conn (M.S., M.V.R.)
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