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Management of Diaphragm Paralysis and Eventration
Camille Yongue1, Travis C Geraci1, Stephanie H Chang1
1Department of Cardiothoracic Surgery, Division of Thoracic Surgery, New York University Langone Health, 530 First Avenue, Suite 9V, New York, NY 10016, USA.
Thoracic Surgery Clinics
|May 5, 2024
Summary
Elevated diaphragm, often found incidentally, can cause symptoms. Diaphragm plication surgery is a safe and effective treatment for symptomatic patients, improving lung function and reducing paradoxical motion.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Medical Imaging
Background:
- Elevated diaphragm, caused by eventration or paralysis, is frequently asymptomatic and discovered incidentally.
- Differentiating between eventration and paralysis can be achieved using fluoroscopic testing to assess for paradoxical motion.
Purpose of the Study:
- To review the indications, surgical approaches, and outcomes of diaphragm plication for elevated diaphragm.
- To highlight diaphragm plication as a treatment for symptomatic patients regardless of the underlying cause.
Main Methods:
- Review of diagnostic methods including fluoroscopy for differentiating diaphragm paralysis from eventration.
- Discussion of surgical techniques for diaphragm plication, emphasizing minimally invasive thoracoscopic approaches.
- Analysis of the goals and outcomes of diaphragm plication.
Main Results:
- Diaphragm plication is indicated for all symptomatic patients with an elevated diaphragm.
- Minimally invasive thoracoscopic plication is a common surgical approach.
- The procedure aims to enhance lung volumes and correct paradoxical hemidiaphragm movement.
Conclusions:
- Diaphragm plication is a safe procedure with excellent outcomes.
- Symptom improvement is consistently associated with diaphragm plication in affected patients.
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