IMPACT OF PHRENIC NERVE PARALYSIS ON THE SURGICAL OUTCOME OF INTERCOSTAL NERVE TRANSFER

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 47-52 ◽  
Author(s):  
Yusuke Kita ◽  
Yasuhito Tajiri ◽  
Shinya Hoshikawa ◽  
Yukinori Hara ◽  
Junichi Iijima
Keyword(s):  
Phrenic Nerve ◽  
Biceps Brachii ◽  
Nerve Transfer ◽  
Intercostal Nerve ◽  
Respiratory Complications ◽  
Radiographic Images ◽  
Nerve Paralysis ◽  
Phrenic Nerve Paralysis ◽  
High Incidence ◽  
One Year

Brachial plexus injuries (BPI) can be complicated by diaphragmatic paralysis (DP). This study determined the influence of DP on biceps brachii (BB) recovery after intercostal nerve transfer (ICNT) for BPI and investigated the respiratory complications of ICNT. The study included 100 patients, 84 showing no DP in preoperative and early postoperative chest radiographic images (non-DP group) and 16 with DP that persisted for over one year after surgery (DP group). The postoperative reinnervation time did not differ between groups. BB strength one year after surgery was lower in the DP group than non-DP group (p = 0.0007). No differences were observed 2–3 years after surgery. In the DP group, four patients had respiratory symptoms that affected daily activities and their outcomes deteriorated (p = 0.04). Phrenic nerve transfer should not be combined with ICNT in patients with poor respiratory function because of the high incidence of respiratory complications.

Phrenic nerve paralysis due to vincristine

2007 ◽  
Vol 48 (12) ◽  
pp. 2452-2453 ◽  
Author(s):  
Paul Gilliland ◽  
Mark Holguin
Keyword(s):  
Phrenic Nerve ◽  
Nerve Paralysis ◽  
Phrenic Nerve Paralysis

Long-term Observation of Respiratory Function After Unilateral Phrenic Nerve and Multiple Intercostal Nerve Transfer for Avulsed Brachial Plexus Injury

Neurosurgery ◽  
2012 ◽  
Vol 70 (4) ◽  
pp. 796-801 ◽  
Author(s):  
Mou-Xiong Zheng ◽  
Yan-Qun Qiu ◽  
Wen-Dong Xu ◽  
Jian-Guang Xu
Keyword(s):  
Pulmonary Function ◽  
Brachial Plexus ◽  
Phrenic Nerve ◽  
Respiratory Function ◽  
Nerve Transfer ◽  
Intercostal Nerve ◽  
Adult Patients ◽  
Significant Difference ◽  
Intercostal Nerves

Abstract BACKGROUND: Phrenic nerve transfer (PNT) or multiple intercostal nerve transfer (MIT) alone are reported to have no significant impact on pulmonary function in the short or medium term, but it has rarely been reported whether the combination of PNT-MIT could influence respiratory function in the long term. OBJECTIVE: Respiratory function was evaluated after PNT and PNT-MIT 7 to 19 years (mean, 10 years) postoperatively. METHODS: Twenty-three adult patients with brachial plexus avulsion injuries who underwent PNT-MIT were compared with 19 corresponding patients who underwent PNT. Pulmonary function testings, phrenic nerve conduction study, and chest fluoroscopy were performed. In the PNT-MIT group, further investigation was performed on the effect of the number of transferred intercostal nerves and the timing of MIT. RESULTS: In the PNT-MIT group, forced vital capacity, forced expiratory volume in one second, and total lung capacity were 73.69%, 72.04%, and 74.81% of predicted values without significant differences from the PNT group. Diaphragmatic paralysis permanently existed with 1 to 1.5 intercostal spaces (ICSs) elevation and near 1 ICS reduced excursion. There was no statistical difference between the PNT and PNT-MIT groups. Furthermore, 3 and 4 intercostal nerves transferred resulted in no further decrease in pulmonary function test results than 2 intercostal nerves. No significant difference was found when PNT and MIT were performed at the same stage or with an interval. CONCLUSION: PNT-MIT did not result in additional impairment in respiratory function in adult patients compared with PNT alone. It is safe to transfer 2 to 4 intercostal nerves at 1 to 2 months delay after PNT.

Rapidly progressive multifocal motor neuropathy with phrenic nerve paralysis: effect of nocturnal assisted ventilation

1998 ◽  
Vol 245 (9) ◽  
pp. 613-616 ◽  
Author(s):  
G. Cavaletti ◽  
Alessandra Zincone ◽  
Laura Marzorati ◽  
Lodovico Frattola ◽  
Franco Molteni ◽  
...  
Keyword(s):  
Phrenic Nerve ◽  
Multifocal Motor Neuropathy ◽  
Assisted Ventilation ◽  
Motor Neuropathy ◽  
Nerve Paralysis ◽  
Phrenic Nerve Paralysis
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