Abstract
Introduction
While a significant body of literature exists on the intracranial part of deep brain stimulation surgery, the equally important second part of the intervention related to the subcutaneous tunneling of deep brain stimulation extension wires is rarely described. The tunneling strategy can consist of a single passage of the extension wires from the frontal incision site to the subclavicular area, or of a two-step approach that adds a retro-auricular counter-incision. Each technique harbors the risk of intraoperative and postoperative complications.
Method
At our center, we perform a two-step tunneling procedure that we developed based on a cadaveric study.
Results
In 125 consecutive patients operated since 2002, we did not encounter any complication related to our tunneling method.
Conclusion
Insufficient data exist to fully evaluate the advantages and disadvantages of each tunneling technique. It is of critical importance that authors detail their tunneling modus operandi and report the presence or absence of complications. This gathered data pool may help to formulate a definitive conclusions on the safest method for subcutaneous tunneling of extension wires in deep brain stimulation.
Abbreviations
- DBS:
-
Deep brain stimulation
- EW:
-
Extension wires
- IPG:
-
Internal Pulse Generator
References
Fabiano AJ, Plunkett RJ (2010) Approach for tunneling the lead in deep brain stimulation. J Neurosurg 112(6):1277–1278
Linhares P, Carvalho B, Vaz R (2013) One-step tunneling of DBS extensions-a technical note. Acta Neurochir (Wien) 155(5):837–840
Machado A, Rezai AR, Kopell BH, Gross RE, Sharan AD, Benabid AL (2006) Deep brain stimulation for Parkinson's disease: surgical technique and perioperative management. Mov Disord 21(Suppl; 14):S247–S258
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The authors state that they have nothing to declare.
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Fontaine, D., Vandersteen, C., Saleh, C. et al. Two-step tunneling technique of deep brain stimulation extension wires—a description. Acta Neurochir 155, 2399–2402 (2013). https://doi.org/10.1007/s00701-013-1870-2
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DOI: https://doi.org/10.1007/s00701-013-1870-2