Presentation
Selective left neck dissection for thyroid operation. Cough post-operatively.
Patient Data
Age: 50 years
Gender: Female
Coronal C+ portal venous phase
Pre-operative CT.
3 cm nodule at the base of the neck with peripheral enhancement and low attenuation centrally in keeping with thyroid malignancy.
Intrathoracic stomach, but otherwise normal chest appearances.
From the case:
Left phrenic nerve palsy
Frontal
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 dyspnea, 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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