Presentation
Selective left neck dissection for thyroid operation. Cough post-operatively.
Patient Data
Age: 50 years
Gender: Female
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Pre-operative CT.
3 cm nodule at the base of the neck with peripheral enhancement and low attenuation centrally in keeping with thyroid malignancy.
Intrathoracic stomach, but otherwise normal chest appearances.
From the case:
Left phrenic nerve palsy
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Elevated left hemidiaphragm. No evidence of consolidation or atelectasis. No pneumothorax.
Surgical clips at base of left neck.
Case Discussion
Phrenic nerve palsy or paralysis occurs in about 10% of neck dissection cases.
Symptoms include dyspnea, coughing, chest pain and an increased risk of atelectasis.
A gradual improvement in symptoms could be expected, however the patient is likely to be left with a raised hemidiaphragm.
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