Reinnervation of the Diaphragm After Bilateral Phrenic Nerve Resection and Immediate Reconstruction Using a Contralateral Phrenic Nerve Autograft
| Autor: | Paolo Persichetti, Francesco Stilo, Marco Morelli Coppola, Stefania Tenna, Livio Cortese, Beniamino Brunetti, Pierfilippo Crucitti, Filippo Longo, Francesco Spinelli |
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| Rok vydání: | 2020 |
| Předmět: |
Mechanical ventilation
medicine.medical_specialty business.industry medicine.medical_treatment Diaphragm Mediastinum Sural nerve musculoskeletal system Respiration Artificial Transplantation Autologous Surgery Diaphragm (structural system) Phrenic Nerve surgical procedures operative medicine.anatomical_structure medicine Humans Diaphragmatic excursion Radical surgery Autografts business Reinnervation Phrenic nerve |
| Zdroj: | Annals of Plastic Surgery. 85:527-530 |
| ISSN: | 1536-3708 0148-7043 |
| Popis: | A patient affected by a voluminous synovial sarcoma of mediastinum received radical surgery, resulting in injury of both phrenic nerves. Because of the cancer location, reconstruction of the left phrenic nerve was not possible, so to prevent the patient's ventilator dependence, the right phrenic nerve was reconstructed via an autograft from the residual proximal stump of the contralateral one. In 3 months, the right hemidiaphragm function showed a full recovery, documented by ultrasonographic and radiographic assessment of diaphragmatic excursion, and the patient was weaned from mechanical ventilation. When a nerve autograft is indicated, the sural nerve still remains the criterion standard, because of the low morbidity of the donor site and ease of harvesting; however, in particular situations, such as in this unique case, the choice of an orthotopic graft may offer promising results. |
| Databáze: | OpenAIRE |
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