Diaphragm paralysis refers to the progressive weakening of the muscle of the diaphragm that leads to an elevation of the diaphragm. This leads to shortness of breath for the patient. The paralysis is caused by injury to the phrenic nerve that controls the diaphragm or injury to the diaphragm muscle. The causes of paralysis are trauma, inflammation, mass effect, or idiopathic.
The diagnosis of diaphragm paralysis is made with a “sniff” test that is performed in radiology. The patient “sniffs” under an X-ray and if there is paradoxical motion of the diaphragm on one side, it confirms unilateral diaphragm paralysis.
In order to provide the best surgical outcome, we obtain the following tests:
- CT of chest—This study is performed in radiology. This study is performed to determine if there is any mass that is causing compression of the phrenic nerve.
- Pulmonary function test—This study is performed in the pulmonary lab. The patient breathes into a tube that provides the overall function of the lung.
In our practice, we treat patients with symptomatic unilateral diaphragm paralysis. We often wait about a year prior to recommending surgery since at times the function of the diaphragm returns spontaneously. We perform robot-assisted diaphragm plication to resolve diaphragm paralysis.