Evaluation of Laryngeal Function after Implantation of the Vagus Nerve Stimulation Device

Abstract

Precise vagus nerve measurements and electrode selection appear to decrease the incidence of nerve compression injury and TVC immobility.

Lead breakage and vocal cord paralysis following blunt neck trauma in a patient with vagal nerve stimulator

“…The surgeon should also measure the diameter of the vagus nerve and choose an appropriate sized electrode array. Santos noted that 11 of 18 patients had nerves that measured more than 2 mm in diameter [12]. Similarly, Shaw et al observed that 6 of 13 patients had vagal nerve measurements≥ 2 mm [6].…”

“…Vocal cord paresis of short duration is commonly seen immediately following surgery and is thought to be the result of direct manipulation of the vagal nerve [11,12]. Hoarseness as an initial side effect of VNS placement has been reported in up to one third of patients [13].…”

Biomechanical and functional variation in rat sciatic nerve following cuff electrode implantation

“…Studies of clinical implantations of vagal nerve stimulators have shown significant mechanical impact including tensile and compressive loading [67-70] as well as functional changes such as vocal function, voice alteration, dyspnea, coughing and aspiration [24], [25], [46]. Some severity in the resulting functional alterations has been alleviated by better matching lead coil diameter to nerve diameter [71]. …”

Intraoperative and perioperative complications with a vagus nerve stimulation device

“…Trauma to the vagus nerve may be prevented by careful neck dissection or sizing of the electrode array. In a series of 18 patients, the diameter of the implanted helical electrode bipolar array was determined by the diameter of the vagus nerve [34]. Vocal cord damage and voice alteration were not reported in this small series, which sought to demonstrate that appropriate sizing would prevent compression of the vagus nerve.…”