Successful immediate phrenic nerve reconstruction during mediastinal tumor resection

Schoeller, Thomas; Öhlbauer, M.; Wechselberger, Gottfried; Piza‐Katzer, Hildegunde; Margreiter, Raimund

doi:10.1067/mtc.2001.117274

Cited by 24 publications

(14 citation statements)

References 5 publications

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“…On the other hand, Schoeller et al reported that immediate microsurgical reconstruction of the phrenic nerve with a nerve graft, which is less invasive, could be effective for symptomatic hemidiaphragmatic paralysis. 12 However, they recommended this procedure only if there was an adequate time frame to allow complete reinnervation, considering that a nerve regenerates at a velocity of 1 mm per day from the proximal nerve to the diaphragm, and if the patient's general condition enabled the extra operating time needed for reconstruction without increasing the risk. Therefore, in selected patients, reconstruction of the phrenic nerve is an excellent method of reanimating the diaphragm.…”

Section: Discussionmentioning

confidence: 98%

Mediastinal Neurofibroma Originating from the Left Intrathoracic Phrenic Nerve: Report of a Case

et al. 2004

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We report a case of mediastinal neurofibroma originating from the left phrenic nerve in a 42-year-old woman who was referred to us after a routine chest X-ray showed a smooth, round abnormal shadow in the left middle lung field adjacent to the heart. We resected a 25 x 20 x 20-mm tumor by video-assisted thoracic surgery. Histopathological examination confirmed that the lesion was a mediastinal neurofibroma originating from the left phrenic nerve without von Recklinghausen's disease. Neurogenic mediastinal tumors originating from the phrenic nerve are very rare, and to the best of our knowledge, no other case of a mediastinal neurofibroma originating from the phrenic nerve in a patient without von Recklinghausen's disease has ever been reported.

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Section: Discussionmentioning

confidence: 98%

Mediastinal Neurofibroma Originating from the Left Intrathoracic Phrenic Nerve: Report of a Case

et al. 2004

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“…In the field of thoracic surgery, Schoeller et al (19) reported successful phrenic nerve reconstruction using sural nerve in patient with mediastinal tumor resection. Telaranta reported that reconstruction of the sympathetic chain using sural nerve graft diminished compensatory sweating in a male patient who underwent sympathicotomy for palmar hyperhidrosis (20).…”

Section: Discussionmentioning

confidence: 99%

Sympathetic Nerve Reconstruction for Compensatory Hyperhidrosis after Sympathetic Surgery for Primary Hyperhidrosis

et al. 2010

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We performed sympathetic nerve reconstruction using intercostal nerve in patients with severe compensatory hyperhidrosis after sympathetic surgery for primary hyperhidrosis, and analyzed the surgical results. From February 2004 to August 2007, sympathetic nerve reconstruction using intercostal nerve was performed in 19 patients. The subjected patients presented severe compensatory hyperhidrosis after thoracoscopic sympathetic surgery for primary hyperhidrosis. Reconstruction of sympathetic nerve was performed by thoracoscopic surgery except in 1 patient with severe pleural adhesion. The median interval between the initial sympathetic surgery and sympathetic nerve reconstruction was 47.2 (range: 3.5-110.7) months. Compensatory sweating after the reconstruction surgery improved in 9 patients, and 3 out of them had markedly improved symptoms. Sympathetic nerve reconstruction using intercostal nerve may be one of the useful surgical options for severe compensatory hyperhidrosis following sympathetic surgery for primary hyperhidrosis.

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“…11,12 Although plication of the diaphragm has been the surgical treatment option most familiar to clinicians, scattered case reports and a vast experience performing phrenic nerve reconstruction at our centers over the last 10 years has demonstrated it to be an effective alternative. [13][14][15][16] Phrenic nerve reconstruction is specifically aimed at restoring diaphragmatic functional activity, something plication surgery does not achieve. Nerve reconstruction generally requires longer follow-up periods than static procedures due to the gradual neuromuscular recovery that occurs in accordance with the sequential processes of peripheral nerve regeneration and muscle strengthening.…”

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confidence: 99%

Long-Term Follow-Up after Phrenic Nerve Reconstruction for Diaphragmatic Paralysis: A Review of 180 Patients

Kaufman

Elkwood

Brown

et al. 2016

J reconstr Microsurg

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Phrenic nerve reconstruction has been evaluated as a method of restoring functional activity and may be an effective alternative to diaphragm plication. Longer follow-up and a larger cohort for analysis are necessary to confirm the efficacy of this procedure for diaphragmatic paralysis. A total of 180 patients treated with phrenic nerve reconstruction for chronic diaphragmatic paralysis were followed for a median 2.7 years. Assessment parameters included: 36-Item Short Form Health Survey (SF-36) physical functioning survey, spirometry, chest fluoroscopy, electrodiagnostic evaluation, a five-item questionnaire to assess specific functional issues, and overall patient-reported outcome. Overall, 134 males and 46 females with an average age of 56 years (range: 10-79 years) were treated. Mean baseline percent predicted values for forced expiratory volume in 1 second, forced vital capacity, vital capacity, and total lung capacity, were 61, 63, 67, and 75%, respectively. The corresponding percent improvements in percent predicted values were: 11, 6, 9, and 13% ( ≤ 0.01; ≤ 0.01; ≤ 0.05; ≤ 0.01). Mean preoperative SF-36 physical functioning survey scores were 39%, and an improvement to 65% was demonstrated following surgery ( ≤ 0.0001). Nerve conduction latency, improved by an average 23% ( ≤ 0.005), and there was a corresponding 125% increase in diaphragm motor amplitude ( ≤ 0.0001). A total of 89% of patients reported an overall improvement in breathing function. Long-term assessment of phrenic nerve reconstruction for diaphragmatic paralysis indicates functional correction and symptomatic relief.

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Successful immediate phrenic nerve reconstruction during mediastinal tumor resection

Cited by 24 publications

References 5 publications

Mediastinal Neurofibroma Originating from the Left Intrathoracic Phrenic Nerve: Report of a Case

Mediastinal Neurofibroma Originating from the Left Intrathoracic Phrenic Nerve: Report of a Case

Sympathetic Nerve Reconstruction for Compensatory Hyperhidrosis after Sympathetic Surgery for Primary Hyperhidrosis

Long-Term Follow-Up after Phrenic Nerve Reconstruction for Diaphragmatic Paralysis: A Review of 180 Patients

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