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Phrenic nerve paralysis following neck dissection

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Summary

One of the complications of neck dissection to control regional metastatic disease in cancer of the head and neck is phrenic nerve paralysis. The resulting elevation of the ipsilateral diaphragm can be diagnosed on a postoperative chest X-ray and confirmed by fluoroscopy. Symptoms can be respiratory, cardiac or gastrointestinal. In a retrospective study, unilateral phrenic nerve paralysis was observed in 14 (8%) of 176 consecutive neck dissections. None of the patients with postoperative phrenic nerve paralysis displayed severe symptoms, although a significantly higher number sustained atelectasis with or without pulmonary infiltrates to complicate the postoperative course.

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References

  1. Alexander C (1966) Diaphragm movements and the diagnosis of diaphragmatic paralysis. Clin Radiol 17:79–83

    Google Scholar 

  2. Arborelius M, Lilja B, Senyk J (1975) Regional and total lung function studies in patients with hemidiaphragmatic paralysis. Respiration 32:253–264

    Google Scholar 

  3. Caliot P (1982) Variations anatomiques de l'origine du nerf phrénique. Rev Laryngol Rhinol Otol 103:239–244

    Google Scholar 

  4. Christensen P (1959) Eventration of the diaphragm. Thorax 14:311–318

    Google Scholar 

  5. Corgill DA (1967) Complications of neck dissection. In: Conley J (ed) Cancer of the head and neck. Butterworth, Washington, pp 191–201

    Google Scholar 

  6. Ewing MR, Martin H (1952) Disability following radical neck dissection. Cancer 5:873–883

    Google Scholar 

  7. Garretsen AJTM, Manni JJ, Vingerhoets HM, Broek P van den (1987) Shoulder disability after radical and modified neck dissections. A clinical study with EMG profile. Clin Otolaryngol 12:467–468

    Google Scholar 

  8. Goetze O (1925) Die effektive Blockade des Nervus phrenicus. Arch Klin Chir 134:595–646

    Google Scholar 

  9. Goffart Y, Moreau P, Biquet JF, Melon J (1988) La paralysie phrenique compliquant la chirurgie cervicofaciale. Acta Otorhinolaryngol Belg 42:564–570

    Google Scholar 

  10. Iverson LIG, Mittal A, Dugan DJ, Samson PC (1976) Injuries to the phrenic nerve resulting in diaphragmatic paralysis with special reference to stretch trauma. Am J Surg 132:263–269

    Google Scholar 

  11. Kelley WO (1950) Phrenic nerve paralysis. Special consideration of the accessory phrenic nerve. J Thorac Surg 19:923–928

    Google Scholar 

  12. Kikuchi T (1970) A contribution to the morphology of the ansa cervicalis and the phrenic nerve. Acta Anat Nippon 45:242–282

    Google Scholar 

  13. King PS, Lewis FR, Weddle JL, Fowlks EW (1973) Effects of radical neck dissection on total rehabilitation of the laryngectomee. Am J Phys Med 52:1–17

    Google Scholar 

  14. Lanz T von, Wachsmuth W (1955) Praktische Anatomie, Vol I/2. Springer, Berlin Göttingen Heidelberg, S 37–63

  15. Malin JP (1979) Zur Ätiologie der Phrenicusparese. Nervenarzt 50:448–456

    Google Scholar 

  16. Mickell J (1978) Clinical implications of postoperative unilateral phrenic nerve paralysis. J Thorac Cardiovasc Surg 76: 297–304

    Google Scholar 

  17. Moorthy SS, Gibbs PS, Losasso AM, Lingeman RE (1983) Transient paralysis of diaphragm following radical neck surgery. Laryngoscope 93:642–644

    Google Scholar 

  18. Overbeeke AJ van, Noordijk JA, Molenaar JC (1983) Acquired diaphragmatic eventration in neonates and infants (in Dutch). Ned Tijdschr Geneeskd 127:1945–1948

    Google Scholar 

  19. Simpson SA, Gordon SS, Jorgens J, Rigler LG (1956) Roentgen changes following radical neck dissection. Radiology 67: 704–713

    Google Scholar 

  20. Swift TR (1970) Involvement of peripheral nerves in radical neck dissection. Am J Surg 119:694–698

    Google Scholar 

  21. Williams PL, Warwick R (1980) Gray's anatomy. Churchill Livingstone, New York, pp 1093–1094

    Google Scholar 

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de Jong, A.A., Manni, J.J. Phrenic nerve paralysis following neck dissection. Eur Arch Otorhinolaryngol 248, 132–134 (1991). https://doi.org/10.1007/BF00178921

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  • DOI: https://doi.org/10.1007/BF00178921

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