title: Two-step tunneling technique of deep brain stimulation extension wires-a description.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Service de Neurochirurgie, CHU de Nice, France, fontaine.d@chu-nice.fr.
authors.forename: Denys
authors.initials: D
authors.lastname: Fontaine
authors.forename: Clair
authors.initials: C
authors.lastname: Vandersteen
authors.forename: Christian
authors.initials: C
authors.lastname: Saleh
authors.forename: Daniel
authors.initials: D
authors.lastname: von Langsdorff
authors.forename: Gilles
authors.initials: G
authors.lastname: Poissonnet
mesh_terms: D002102:Cadaver; D046690:Deep Brain Stimulation / Q000379:methods*; D004567:Electrodes, Implanted; D006801:Humans; D010300:Parkinson Disease / Q000473:pathology / Q000628:therapy; D011183:Postoperative Complications / Q000517:prevention & control