Objectives: A supraclavicular insertion approach for vagus nerve stimulation (VNS) may permit a wider range of VNS settings compared to traditional insertion techniques due to increased anatomic distance between VNS leads and the recurrent laryngeal nerve. Beyond potential technical advantages, this approach could offer greater cosmetic satisfaction for patients. However, the safety and efficacy of the supraclavicular approach is uncertain. We compared safety and efficacy of supraclavicular versus mid-neck insertion techniques for VNS in the treatment of pediatric drug-resistant epilepsy (DRE).
Methods: Single-center retrospective analysis of children with epilepsy (< 21 years of age) who received VNS via supraclavicular or mid-neck insertion from May 2017 to December 2022. Continuous variables were compared using Wilcoxon rank-sum tests, while categorical variables were analyzed with Fisher's exact tests.
Results: The study included a total of 88 patients (Male/Female:38/50), with 18 having supraclavicular and 70 mid-neck VNS insertions. No significant differences between groups were found in demographics, clinical/seizure characteristics, VNS settings, side-effect profile related to VNS surgery or stimulation, or seizure outcomes at last follow up.
Conclusions: The supraclavicular approach to VNS does not differ from the mid-neck method in terms of efficacy and overall safety profile. Future research with a larger cohort and longer-term follow-up is needed to explore the clinical significance of VNS settings in the context of different lead locations.
Keywords: Implantation; Pediatric; Techniques; VNS.
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.