HomePhilippine Journal of Otolaryngology Head and Neck Surgeryvol. 24 no. 2 (2009)

Laryngeal Trauma with Phrenic Nerve Injury: A Rare Association

Noor Dina Hashim | Mohd Razif Mohamad Yunus | Marina Mat Baki | Mazita Ami

 

Abstract:

Objectives: To share our experience in managing a rare involvement of phrenic nerve injury in laryngeal trauma.
Methods:
Design: Case Report
Setting: Tertiary Referral Centre
Patient: One
Results: A 23-year-old male sustained blunt laryngeal trauma associated with phrenic nerve injury leading to silent traumatic diaphragmatic paralysis. He underwent tracheotomy and surgical repair of Schaeffer class IV laryngeal injuries, and conservative therapy for the diaphragmatic paralysis, which eventually resolved.
Conclusion: Patients with laryngeal trauma may have concomitant phrenic nerve injury causing diaphragmatic paralysis. The diagnosis should be considered particularly if the patient has respiratory problems despite securing the airway by tracheotomy. A high index of suspicion is required in diagnosing such an association. Patients should be closely monitored even though most will recover as some may present with later morbidities. A search of PubMed and OvidSP using the terms “larynx,” “laryngeal trauma” and “phrenic nerve” did not yield any report of phrenic nerve injury in association with laryngeal trauma. To our knowledge, this is may be the first reported case of phrenic nerve injury in association with blunt laryngeal trauma.