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Management and outcome of vagus nerve stimulator implantation: experience of an otolaryngeal/neuropediatric cooperation.
Grasl, S; Janik, S; Dressler, A; Diehm, R; Gröppel, G; Eichinger, K; Grasl, M C; Gstoettner, W; Feucht, M; Vyskocil, E; Baumgartner, W D.
Afiliação
  • Grasl S; Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
  • Janik S; Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
  • Dressler A; Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Intensive Care Medicine and Neuropediatrics, Medical University of Vienna, Partner of the ERN EpiCARE, Vienna, Austria.
  • Diehm R; Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Intensive Care Medicine and Neuropediatrics, Medical University of Vienna, Partner of the ERN EpiCARE, Vienna, Austria.
  • Gröppel G; Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Intensive Care Medicine and Neuropediatrics, Medical University of Vienna, Partner of the ERN EpiCARE, Vienna, Austria.
  • Eichinger K; Department of Children and Adolescent Medicine, Hospital of St. John of God, Eisenstadt, Austria.
  • Grasl MC; Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
  • Gstoettner W; Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
  • Feucht M; Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Intensive Care Medicine and Neuropediatrics, Medical University of Vienna, Partner of the ERN EpiCARE, Vienna, Austria. martha.feucht@meduniwien.ac.at.
  • Vyskocil E; Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria. erich.vyskocil@meduniwien.ac.at.
  • Baumgartner WD; Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
Eur Arch Otorhinolaryngol ; 278(10): 3891-3899, 2021 Oct.
Article em En | MEDLINE | ID: mdl-34196736
OBJECTIVE: Vagus nerve stimulator (VNS) implantation is an established therapy for pharmacoresistant epilepsy that is not amenable to curative epilepsy surgery. Historically, VNS implantation has been performed by neurosurgeons, but otolaryngologist involvement is increasingly common. In this retrospective study, we aimed to evaluate the efficacy and safety of VNS implantation in children and adolescents from the otolaryngologists' perspective. METHODS: This study included children and adolescents who had undergone VNS implantation at the study center between 2014 and 2018. Patient files were analyzed with regards to the durations of device implantation and hospitalization, postoperative complications, and clinical outcome, including seizure frequency, clinical global impression of improvement (CGI-I) score, and quality of life (QoL). RESULTS: A total of 73 children underwent VNS surgery. The median age at implantation was 9.3 ± 4.6 years, and median epilepsy duration before VNS surgery was 6 ± 4 years. Lennox-Gastaut syndrome was the most common syndrome diagnosis (62.3%), and structural abnormalities (49.3%) the most frequent etiology. Operation times ranged from 30 to 200 min, and median postoperative hospitalization length was 2 ± 0.9 days. No complications occurred, except for four revisions and two explantations due to local infections (2.7%). Among our patients, 76.7% were responders (≥ 50% reduction in seizure frequency), 72.1% showed improved CGI-I scores, and 18.6-60.5% exhibited considerable improvements in the QoL categories energy, emotional health, and cognitive functions. CONCLUSION: Our results indicate that VNS implantation is a highly effective and safe treatment option for children and adolescents with AED-refractory epilepsies who are not candidates for curative epilepsy surgery.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Qualidade de Vida / Estimulação do Nervo Vago Tipo de estudo: Observational_studies Aspecto: Patient_preference Limite: Adolescent / Child / Humans Idioma: En Revista: Eur Arch Otorhinolaryngol Assunto da revista: OTORRINOLARINGOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Áustria País de publicação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Qualidade de Vida / Estimulação do Nervo Vago Tipo de estudo: Observational_studies Aspecto: Patient_preference Limite: Adolescent / Child / Humans Idioma: En Revista: Eur Arch Otorhinolaryngol Assunto da revista: OTORRINOLARINGOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Áustria País de publicação: Alemanha