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The phrenic nerve controls function of the diaphragm muscle; the primary muscle involved in breathing. Contraction of the diaphragm muscle permits expansion of the chest cavity and inhalation of air into the lungs. When an injury to the phrenic nerve occurs, this results in a condition known as diaphragm paralysis.

Diaphragm paralysis was once thought to be incurable. However, recent advances in medicine have done away with this myth. Led by the renowned Dr. Matthew Kaufman, our surgical team provides world-class treatment for phrenic nerve injury in order to reverse diaphragm paralysis.


Symptoms of Phrenic Nerve Damage

Phrenic nerve injury that results in diaphragm paralysis can significantly decrease quality of life. A paralyzed diaphragm can be either unilateral (on one side of the muscle) or bilateral (on both sides of the muscle). Regardless of the specific type of diaphragm paralysis, the symptoms are generally the same, including:

  • Chronic shortness of breath
  • Low levels of energy
  • Inability to perform tasks without feeling winded
  • Persistent sleep disturbances

Causes & Risk Factors

Causes of phrenic nerve injury can vary from accidents and trauma to infections and diseases. Some of the known causes and risk factors include:

  • A surgical injury, from procedures such as lung surgery, heart valve surgery, aorta surgery, thymus gland surgery, carotid-subclavian bypass surgery, or thoracic outlet syndrome surgery
  • An anesthetic injury, such as injury from epidural injections or interscalene nerve blocks
  • Cancer in the lungs or lymph nodes
  • Birth trauma
  • Spinal cord disorders
  • Quadriplegia
  • Trauma, such as falling from a horse, car accidents, or sports accidents
  • Chiropractic manipulation of the neck

Sometimes, we are unable to pinpoint a direct cause for a phrenic nerve injury that results in diaphragm paralysis. When this occurs, we refer to the condition as Idiopathic Diaphragm Paralysis. From our vast experience in evaluating thousands, and treating hundreds of patients over the last fifteen years, we have clearly identified that most cases of Idiopathic Diaphragm Paralysis are actually a result of chronic peripheral nerve compression in the neck region.

Diagnosing Phrenic Nerve Damage

To determine if our revolutionary treatment options can help you, we will begin with a consultation. One of our patient coordinators will use this time to discover more about your condition, such as when you were diagnosed, what caused the damage, symptoms, previous tests, and more. To expedite the process, we ask that you come prepared with a confirmed diagnosis for a paralyzed diaphragm.

Following this consultation, we will collaboratively decide if moving forward with us is the best option for you and which procedure is right for you. Once we determine you are an ideal candidate, we may perform additional diagnostic testing to determine the cause, if possible, and to decide which procedure would be best for you. Tests may include:

  • MRI, if we suspect chronic peripheral nerve compression
  • CT scan
  • Blood or urine tests
  • Additional diagnostic testing to rule out the possibility of a viral cause or a generalized neurological disorder

Phrenic Nerve Damage Treatments

Until recently, treatment options for phrenic nerve injury have been limited to either nonsurgical therapy or diaphragm plication, neither of which attempts to restore normal function to the paralyzed diaphragm. Many patients with phrenic nerve injuries have been told that they must simply learn to live with this deficit.

The Institute for Advanced Reconstruction is one of the only practices in the world to offer several groundbreaking procedures to treat diaphragm paralysis caused by phrenic nerve damage.

Phrenic nerve reconstruction
Developed by The Institute for Advanced Reconstruction physician Dr. Matthew Kaufman, this procedure is a world-class treatment for phrenic nerve injury to reverse diaphragm paralysis.

Dr. Kaufman is the only known expert in the world to perform phrenic nerve reconstruction surgery. He has completed nearly 800 successful diaphragm paralysis reversal surgeries, pioneering a new era of phrenic nerve injury treatment. Patients from around the world visit our practice to find relief and renewed hope.

Phrenic nerve breathing pacemaker surgery
In this procedure, surgeons implant a breathing pacemaker to control the diaphragm muscle. Electrodes are placed either around the nerves or directly into the muscle to cause an inhalation event.

The Institute for Advanced Reconstruction is one of the only places worldwide that performs diaphragm pacemaker implantation in select patients with unilateral or bilateral diaphragm paralysis due to phrenic nerve injury. We have vast experience in combining pacemakers with nerve reconstruction to optimize recovery in the most complex cases of diaphragm paralysis.

Diaphragm muscle replacement surgery
For some patients, phrenic nerve surgery and diaphragm pacemakers are not the right solutions, especially when the condition has been present for many years, or if the individual has previously undergone diaphragm plication. In these cases, we recommend diaphragm muscle replacement surgery. This procedure involves transferring healthy muscle from the patient’s body into the chest cavity, effectively replacing the irreversibly damaged diaphragm and restoring functional breathing activity.

In the past, the procedure had been limited to use in children with congenital diaphragm problems. Now, Dr. Kaufman and his team have found a way to offer it to both children and adults who experience diaphragm paralysis.

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