Original articleGeneral thoracicFunctional Restoration of Diaphragmatic Paralysis: An Evaluation of Phrenic Nerve Reconstruction
Section snippets
Patients and Methods
The Jersey Shore University Medical Center (Neptune, NJ) Institutional Review Board approved the study, and informed patient consent was obtained in accordance with study approval.
PS Group
The PS group comprised 53 male and 15 female patients, with an average age of 53 years (range, 11 to 79 years) and a mean body mass index of 30.2 ± 5.3 kg/m2 (Table 1). The paralysis was left-sided in 40 patients and right-sided in 28. All patients provided a history of an episodic or recurrent iatrogenic or traumatic event or events (Table 2). The average duration between onset of respiratory symptoms and surgical treatment was 22 months (range, 8 to 72 months). The follow-up period after
Comment
Diaphragmatic paralysis is a disorder that is not readily recognized, primarily because it is unlike many other respiratory diseases in which the underlying pathophysiology affects the airways or lung parenchyma, or both. Respiratory deficits caused by dysfunction of the primary respiratory muscle are most often a direct result of injury to its innervation, the phrenic nerve. The etiology can be iatrogenic injury (ie, surgical, anesthetic blocks, chiropractic) or trauma (ie, whiplash, traction
References (28)
- et al.
Incidence and natural history of phrenic neuropathy occurring during open heart surgery
Chest
(1993) - et al.
A 56-year-old woman with arm pain, dyspnea, and an elevated diaphragm
Chest
(2008) The diaphragm
Surg Clin North Am
(2010)- et al.
Surgical treatment of diaphragmatic eventration using video-assisted thoracic surgery: a prospective study
Ann Thorac Surg
(2005) - et al.
Laparoscopic plication for diaphragmatic paralysis and eventration: an objective evaluation of short-term and midterm results
J Thorac Cardiovasc Surg
(2010) - et al.
Reinnervation of the paralyzed diaphragm: Application of peripheral nerve techniques following unilateral phrenic nerve injury
Chest
(2011) - et al.
Considerations in evaluating new treatment alternatives following peripheral nerve injuries: a prospective clinical study of methods used to investigate sensory, motor, and functional recovery
J Plast Reconstr Aesthet Surg
(2007) - et al.
Nerve injuries about the elbow
Clin Sports Med
(2010) - et al.
Bilateral phrenic nerve paralysis manifested by orthopnea for 6 months in a patient with neuralgic amyotrophy
Intern Med
(2009) Respiratory management of diaphragm paralysis
Sem Resp Crit Care Med
(2002)