Surgery of the Phrenic Nerve

Alexander S. Krupnick, R. Brannon Claytor, Susan E. Mackinnon

Key Points

Comprehensive knowledge of phrenic nerve anatomy is essential to avoid injury. First-degree injury (neurapraxia) and second-degree injury (axonotmesis) will resolve in weeks to months; however, more severe injury (third to fifth degree) will not heal. Although it is theoretically possible to repair a transected phrenic nerve, this is uncommonly reported. Diaphragmatic plication and nerve transfers may be necessary for treatment of respiratory compromise after phrenic injury.

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