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Diaphragm plication for unilateral diaphragm paralysis: a case report and review of the literature
- Source :
- Acta clinica Belgica. 68(4)
- Publication Year :
- 2014
-
Abstract
- Unilateral diaphragm paralysis is an often not recognised cause of dyspnoea. We present a patient with a unilateral phrenic nerve paralysis treated with diaphragmatic plication. Patient presented with life-style limiting dyspnoea and pulmonary function showed a decrease in FVC when lying down. Since there was no improvement after respiratory muscle training, plication of the hemidiaphragm was performed by a small thoracotomy. The patient improved with regard to respiratory complaints and lung function. Furthermore, we also demonstrate for the first time a significant improvement in exercise capacity with accompanying striking amelioration of quality of life. The patient is now in follow up up for more than 2 years and the impressive improvement in exercise capacity remains present. Surgical treatment of unilateral diaphragm paralysis has been described in case reports and in small series since 1985. Although comparison of the available data is difficult a diaphragm plication seems an effective and safe procedure for patients with symptomatic, acquired unilateral diaphragm paralysis. Improvement of dyspnoea is present in the majority of patients and we even observed an impressive amelioration in exercise capacity. Consequently, it seems appropriate to propose plication to patients with clear symptoms from the moment spontaneous recovery seems unlikely; yet, prospective randomised controlled studies are needed to prove this. ispartof: Acta Clinica Belgica vol:68 issue:4 pages:311-315 ispartof: location:England status: published
- Subjects :
- medicine.medical_specialty
Diaphragm paralysis
medicine.medical_treatment
Diaphragm
Diaphragmatic breathing
paralysis
Pulmonary function testing
FEV1/FVC ratio
medicine
Paralysis
Humans
Thoracotomy
Respiratory system
business.industry
Peripheral Nervous System Diseases
General Medicine
Middle Aged
Respiratory Paralysis
Surgery
Diaphragm (structural system)
Phrenic Nerve
Dyspnea
Treatment Outcome
Anesthesia
plication
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 17843286
- Volume :
- 68
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Acta clinica Belgica
- Accession number :
- edsair.doi.dedup.....88a6426b31635711c7d2cf7cc2c767ef