Chest
Successful Repair of a Transected Phrenic Nerve with Restoration of Diaphragmatic Function
Section snippets
Case Report
A 20-year-old man presented at the North Central Bronx Hospital with a stab wound of the anterior left chest. His pulse was not palpable and blood pressure unobtainable. An anterior thoracotomy was performed in the emergency ward. The pericardium, which was filled with blood, was opened transversely and a hole in the right ventricle was repaired. It was noted that the left phrenic nerve had been transected. The patient recovered uneventfully except for persistent collapse of the left lower lobe
Comment
Most cases of acquired phrenic nerve paralysis are iatrogenic. The nerve is most frequently damaged during a variety of thoracic and cardiac operations.1 Most often, only one nerve is damaged, but cases of bilateral phrenic nerve paralysis have been reported.
There are isolated case reports of phrenic nerve damage following percutaneous punctures of the subclavian2 and internal jugular veins,3 following intercostal tube drainage4, 5 and after penetrating missile wounds of the chest.9
Paralysis of
ACKNOWLEDGMENT
The microsurgical portion of the nerve reconstruction was performed by Dr. Berish Strauch and Dr. Michael Kalisman.
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Cited by (23)
Experimental Study of Nerve Transfer to Restore Diaphragm Function
2020, World NeurosurgeryCitation Excerpt :Merav et al.21 reported that repair of the phrenic nerve, either directly or with a nerve graft, was feasible. Thirteen months after repair, there was significant improvement in diaphragmatic motion.21 Krieger and Krieger22 described primary nerve transfers to reanimate the diaphragm in patients confined to long-term positive pressure ventilation because of high cervical spine injury.
Reverse end-to-side nerve transfer: From animal model to clinical use
2011, Journal of Hand SurgeryReinnervation of the paralyzed diaphragm: Application of nerve surgery techniques following unilateral phrenic nerve injury
2011, ChestCitation Excerpt :Unfortunately, diaphragmatic pacing generally is performed only in patients with bilateral nerve injury because current technology does not permit timing electronic impulses to physiologically derived respiratory activity. Immediate repair of phrenic nerve transection has been described in the literature in scattered case reports.13,20 Brouillette et al13 reported immediate end-to-end anastamosis in an infant after teratoma resection.
Experimental repair of phrenic nerve using a polyglycolic acid and collagen tube
2007, Journal of Thoracic and Cardiovascular SurgeryPhrenic nerve injury following scalenectomy in a patient with thoracic outlet obstruction
1995, Journal of Clinical AnesthesiaPlication of the diaphragm for infants and young children with phrenic nerve palsy
1988, Journal of Pediatric Surgery
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