Bilateral phrenic nerve stimulators

Case contributed by Dr Craig Hacking

Presentation

Cough. History of cervical cord injury and quadriplegia many years ago.

Patient Data

Age: 28
Gender: Male

Bilateral chest wall nerve stimulators are noted. The tracheostomy tube is well positioned. Allowing for differences in inspiration and projection, lungs and pleural spaces are clear. Heart size and mediastinal contours are unchanged. Scoliosis noted.

 

The patient has a tracheostomy. Bilateral chest wall generators are connected to single thin wires which course anteriorly and enter the chest between the costal cartilages. The metallic tips are located in the lateral aspects of the superior mediastinum at the expected location of the phrenic nerves. These represent phrenic nerve stimulators.

Some retained secretions are present in the lower trachea.

The lungs are clear with no evidence of bronchiectasis or interstitial lung abnormality.

There is a moderate scoliosis of the thoracic spine concave to the left centred in the lower thoracic region with a compensatory component concave to the right centred in the cervicothoracic region.

Case Discussion

Phrenic nerve stimulators are used in patients with spinal cord injury and no phrenic nerve function to aid in respiration.

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Case information

rID: 39375
Case created: 2nd Sep 2015
Last edited: 12th Aug 2017
Inclusion in quiz mode: Included

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