Left phrenic nerve palsy

Case contributed by Derek Smith


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

Patient Data

Age: 50 years
Gender: Female

Pre-operative study


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.


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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