Left phrenic nerve palsy

Case contributed by Dr Derek Smith


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

Patient Data

Age: 50
Gender: Female

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.


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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