Iatrogenic phrenic nerve palsy

: Iatrogenic phrenic nerve injury is an issue that all thoracic surgeons will be called to tackle during their career. Injury of the leads paralysis hemidiaphragm, which can result in a spectrum symptom severity from asymptomatic disabling shortness breath. It any operation requiring dissection close its anatomical pathway neck diaphragm, but also at risk with interventional procedures within vicinity, such as cardiac ablation techniques. range complete, irreversible transection neuropraxia temporary dysfunction. Due this timing intervention individual each patient. Symptoms may mild severe and typical aspecific. Confirmation diagnosis accomplished combination static (CXR, CT) dynamic imaging (ultrasound, fluoroscopy). The presence other co-morbidities obesity, heart conditions or obstructive airways disease potentially contributing same symptoms, makes relative contribution difficult ascertain increase surgical risks. A careful risk/benefit assessment, well optimisation these underlying prior treatment paramount. Treatment options include minimally invasive diaphragmatic plication repair We hereby give overview relevant anatomy aetiology iatrogenic injury, diagnostic work-up different therapeutic options, focus on plication, timing.