The phrenic nerve controls function of the diaphragm muscle - the primary muscle involved in breathing. It tells the diaphragm when to contract, allowing the chest cavity to expand and triggering the inhalation of air into the lungs.
Injury to the phrenic nerve can impair the ability of the nervous system to regulate breathing. It is known risk associated with chest and neck procedures such as coronary bypass surgery (CABG), neck dissection for head and neck cancer, surgery of the lungs, heart valve surgery, surgery of the aorta, thymus gland surgery, carotid-subclavian bypass surgery, and surgery for thoracic outlet syndrome. The phrenic nerve can also be injured by epidural injections, interscalene nerve blocks, and even chiropractic manipulation of the neck.
In the past, treatment options for phrenic nerve injury were limited to either nonsurgical therapy or diaphragm plication, neither of which attempts to restore normal function to the paralyzed diaphragm. Patients endured chronic shortness of breath, sleep disturbances, and lower energy levels. They were often told by their physicians that they would simply have to live with it.
Advances in nerve decompression and transplant allow reconstructive plastic surgeons to reverse diaphragm paralysis. The techniques used are derived from the procedures commonly used to treat arm or leg paralysis, which have allowed surgeons to restore function to previously paralyzed muscle groups.
The rarity of the condition often makes it difficult for patients with a phrenic nerve injury to find treatment. The condition is often mis-diagnosed or viewed as insufficiently severe enough to require corrective surgery.
Patients who have undergone phrenic nerve surgery report improvements in their physical and respiratory function, and a reversal of the sleeping difficulties related to diaphragm paralysis.
If you have been diagnosed with a paralyzed diaphram, you may be a candidate for phrenic nerve repair. In order to expedite your inquiry, please have the following information ready:
UCLA Division of Plastic & Reconstructive Surgery
200 UCLA Medical Plaza, Suite 465
Los Angeles, CA 90095
The Institute for Advanced Reconstruction
at The Plastic Surgery Center
535 Sycamore Avenue
Shrewsbury, NJ 07702
Reinnervation of the Paralyzed Diaphragm: Application of Nerve Surgery Techniques Following Unilateral Phrenic Nerve Injury
Kaufman, MR et al. Chest 2011;140;191-197
Diaphragm Paralysis Caused By Transverse Cervical Artery Compression of the Phrenic Nerve: The Red Cross syndrome
Kaufman, MR et al. Clin Neurol Neurosurg (2012), doi:10.1016/j.clineuro.2012.01.048
Surgical Treatment of Permanent Diaphragm Paralysis After Interscalene Nerve Block for Shoulder Surgery
Kaufman, MR et al. Anesthesiology 2013; 119:4
Reza Jarrahy, MD
Reza Jarrahy, MD earned his bachelor's degree from Stanford University and his medical degree from the State University of New York's Stony Brook School of the Medicine. He completed his general surgery training at New York University and University of California, San Diego, and completed his plastic surgery residency at the David Geffen School of Medicine at UCLA. He elected to complete an additional year of sub-specialty fellowship training in craniofacial surgery at David Geffen School of Medicine at UCLA before joining the UCLA Division of Plastic & Reconstructive Surgery as an assistant professor in 2007. Dr. Jarrahy specializes in the care of pediatric patients with rare and complicated craniofacial disorders. He travels abroad on an annual basis to assist in the care of craniofacial patients in Brazil and Guatemala.