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Lung diseases

Paralyzed right diaphragm

02/03/2010

Question:

I fell 27 feet out of a Tree-stand,broke the lower six ribs on right side,I landed on my butt.I was knock out with drugs and put on a ventilator for 5 days,spent 17 days in Hospital,went home and went to lung Doctor and was put in a chamber to check breathing.One day later had a Hemothroax,took two liters of blood out of pocket,went home had breathing problems and had a Sniff Test,found Right Diaphragm was paralyzed.CT showed nothing that would cause it.Doctor said nerves was dead that controlled the right sight.Can they find where the nerve is damaged or pinched and fix it and if not what happens to the right lung?

Answer:

The nerve was most likely damaged as a result of your recent trauma and fall. Unfortunately, the damaged nerve cannot be directly repaired. Usually, a unilateral (on one side only) paralyzed diaphragm does not cause symptoms. In some cases, patients may notice shortness of breath with exertion or exercise, especially if they also have underlying lung disease. Treatment options are fairly limited, and are considered only in cases where shortness of breath is extremely limiting. Although the paralyzed diaphragm can not be surgically repaired (the damage is actually the result of nerve damage) directly, surgery (a procedure called "plication") may sometimes be helpful to improve the function of the diaphragm on the functioning side. Success with this procedure varies widely, and it involves significant recovery.

In most cases, no treatment is attempted. There is no damage to the lung, and unless other respiratory or neuromuscular problems develop later in life, I would not expect it to give you any significant problems. The diaphragm is not the only muscle used for breathing, and in most cases, the other muscles are able to compensate for the lack of work from the paralyzed diaphragm so that oxygen and carbon dioxide levels are not significantly affected.

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Response by:

Jennifer  McCallister, MD Jennifer McCallister, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University