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Long-Term Follow-Up after Phrenic Nerve Reconstruction for Diaphragmatic Paralysis: A Review of 180 Patients.
- Source :
-
Journal of reconstructive microsurgery [J Reconstr Microsurg] 2017 Jan; Vol. 33 (1), pp. 63-69. Date of Electronic Publication: 2016 Sep 25. - Publication Year :
- 2017
-
Abstract
- Background Phrenic nerve reconstruction has been evaluated as a method of restoring functional activity and may be an effective alternative to diaphragm plication. Longer follow-up and a larger cohort for analysis are necessary to confirm the efficacy of this procedure for diaphragmatic paralysis. Methods A total of 180 patients treated with phrenic nerve reconstruction for chronic diaphragmatic paralysis were followed for a median 2.7 years. Assessment parameters included: 36-Item Short Form Health Survey (SF-36) physical functioning survey, spirometry, chest fluoroscopy, electrodiagnostic evaluation, a five-item questionnaire to assess specific functional issues, and overall patient-reported outcome. Results Overall, 134 males and 46 females with an average age of 56 years (range: 10-79 years) were treated. Mean baseline percent predicted values for forced expiratory volume in 1 second, forced vital capacity, vital capacity, and total lung capacity, were 61, 63, 67, and 75%, respectively. The corresponding percent improvements in percent predicted values were: 11, 6, 9, and 13% ( p ≤ 0.01; ≤ 0.01; ≤ 0.05; ≤ 0.01). Mean preoperative SF-36 physical functioning survey scores were 39%, and an improvement to 65% was demonstrated following surgery ( p ≤ 0.0001). Nerve conduction latency, improved by an average 23% ( p ≤ 0.005), and there was a corresponding 125% increase in diaphragm motor amplitude ( p ≤ 0.0001). A total of 89% of patients reported an overall improvement in breathing function. Conclusion Long-term assessment of phrenic nerve reconstruction for diaphragmatic paralysis indicates functional correction and symptomatic relief.<br /> (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)
- Subjects :
- Adolescent
Adult
Aged
Child
Diaphragm physiopathology
Diaphragm surgery
Electromyography
Female
Fluoroscopy
Follow-Up Studies
Health Surveys
Humans
Male
Middle Aged
Recovery of Function
Respiratory Paralysis physiopathology
Retrospective Studies
Spirometry
Surveys and Questionnaires
Time Factors
Treatment Outcome
Young Adult
Diaphragm innervation
Neurosurgical Procedures methods
Phrenic Nerve surgery
Plastic Surgery Procedures methods
Respiratory Paralysis surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1098-8947
- Volume :
- 33
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of reconstructive microsurgery
- Publication Type :
- Academic Journal
- Accession number :
- 27665114
- Full Text :
- https://doi.org/10.1055/s-0036-1588018