Abstract
Unilateral diaphragm paralysis resulting from peripheral cervical root and/or phrenic neuropathy may result in exertional dyspnea, orthopnea, and sleep disordered breathing. Diaphragm plication has demonstrable benefits despite the absence of functional restoration, but a subset of patients will fail or relapse. Phrenic nerve reconstruction and diaphragm pacemakers have been evaluated as functional alternatives to plication. The aim of nerve reconstruction is to reverse the underlying peripheral nerve injury. Phrenic nerve reconstruction, performed in properly selected patients with unilateral diaphragm paralysis, can restore diaphragm function and improve quality of life. Treatment failures still have the option to pursue diaphragm plication, while plication failures would not likely be candidates for phrenic nerve reconstruction, thus functional surgery may be considered as first line therapy when feasible.
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Kaufman, M.R., Bauer, T. (2020). Does Phrenic Nerve Reconstruction for Unilateral Diaphragm Paralysis Improve Function or Quality of Life. In: Ferguson, M. (eds) Difficult Decisions in Thoracic Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-030-47404-1_43
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DOI: https://doi.org/10.1007/978-3-030-47404-1_43
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