Respiratory evaluation to diagnose unilateral diaphragmatic paralysis in a patient with a cervical prevertebral abscess
A case report
Abstract
Introduction: Unilateral diaphragmatic paralysis (UDP) is often subclinical and may be found incidentally on a chest X-ray (Xr) in patients reporting effort dyspnea. It can be attributable to a phrenic nerve injury, which may be caused during a head and neck surgery. The aim of this study is to describe the respiratory evaluation of a patient with a tentative diagnosis of postoperative UDP.
Case presentation: A 34-year-old male was transferred to our institution with a diagnosis of incomplete spinal cord injury secondary to a cervical prevertebral abscess, which was surgically removed. During his rehabilitation in the intermediate care unit, the patient developed respiratory symptoms, which required several assessments by respiratory therapists. Chest Xr, nasal sniff radioscopy, diaphragmatic ultrasound, maximal static respiratory pressures, vital capacity, and peak cough flow were assessed. The results confirmed the diagnosis of postoperative right UDP.
Conclusion: We described the respiratory evaluation of a patient with a cervical prevertebral abscess, which was removed, and confirmed the diagnosis of right UDP. Both the interdisciplinary approach and the role of the respiratory therapists as a second diagnostic barrier were essential.
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