Left phrenic nerve palsy

Case contributed by Dr Derek Smith

Presentation

Selective left neck dissection for thyroid operation. Cough post-operatively.

Patient Data

Age: 50
Gender: Female
CT

Pre-operative study

Pre-operative CT.

3cm nodule at base of neck with peripheral enhancement and low attenuation centrally in keeping with thyroid malignancy.

Normal chest appearances on topogram and through remainder of study.

X-ray

Elevated left hemidiaphragm. No evidence of consolidation or atelectasis. No pneumothorax.

Surgical clips at base of left neck.

Case Discussion

Phrenic nerve palsy or paralysis occurs in about 10% of neck dissection cases.

Symptoms include dyspnoea, coughing, chest pain and an increased risk of atelectasis.

A gradual improvement in symptoms could be expected, however the patient is likely to be left with a raised hemidiaphragm.

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Case information

rID: 37404
Case created: 6th Jun 2015
Last edited: 7th May 2016
Systems: Chest, Head & Neck
Inclusion in quiz mode: Included

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