Diaphragm paralysis can have a significant impact on a person’s quality of life, causing breathing difficulties and other respiratory issues. In Delhi, patients struggling with this condition have access to various treatment options that aim to improve diaphragm function and alleviate symptoms. From conservative approaches to surgical interventions, Dr Pallavi Purwar offers a range of solutions to address diaphragm paralysis and its associated complications.
Dr Pallavi Purwar offers different treatment options available for diaphragm paralysis in Delhi. The treatment options provided delves into conservative methods, such as respiratory therapy and medication, as well as surgical procedures like diaphragmatic plication and diaphragmatic pacing. After a thorough consultation – Dr Pallavi can provide insights into the most suitable treatment strategies to manage diaphragm paralysis effectively and improve respiratory function.
Understanding Diaphragm Paralysis
Diaphragm paralysis occurs when the muscle responsible for breathing becomes weak or damaged, leading to difficulties in breathing. The diaphragm is the most important part of the respiratory system, and diaphragmatic palsy following cardiac surgery is not uncommon and can cause deterioration of pulmonary functions and attendant pulmonary complications.
Causes of diaphragm paralysis
There are several causes for diaphragm paralysis, including nerve damage, trauma, or certain medical conditions. The causes can be divided into different etiologies:
- Trauma: Considered the most common cause, direct trauma, either blunt trauma or during a surgical procedure, has the potential to injure the phrenic nerve leading to hemidiaphragm weakness or paralysis.
- Compression: Compression of the phrenic nerve, whether from cervical spondylosis, adjacent tumors, malformations, mediastinal chest tubes, or chronic sclerosing mediastinitis, can lead to decreased diaphragm function. Up to 5% of lung cancer cases have shown phrenic nerve involvement.
- Diseases: Disease states that often cause nerve damage or demyelination, such as diabetic neuropathy, multiple sclerosis, and other chronic demyelinating disorders, may interfere with the conduction of the phrenic nerve, leading to diaphragm paralysis or weakness.
- Infections: Viral infections like herpes zoster, Zika, poliovirus, and bacterial infections like Lyme disease have been linked to unilateral diaphragmatic paralysis.
- Nerve blocks: Local spread of anesthetic during nerve blocks for pain control can affect the phrenic nerve, block impulses sent to the diaphragm, and cause unilateral diaphragmatic paralysis.
- Idiopathic: In nearly 20% of cases, the cause of diaphragmatic paralysis is considered unknown or idiopathic.
Symptoms and diagnosis
Patients commonly report dyspnea (shortness of breath) on exertion, especially with intense exercise and exacerbated when lying supine. Dr Pallavi may suggest the diagnosis which is often made with chest X-ray and confirmed by fluoroscopy. Additional tests like pulmonary function tests, imaging studies (X-rays or CT scans), and electromyography may be conducted to assess the electrical activity of the diaphragm.
Impact on breathing and quality of life
With paralysis of the diaphragm, the patient has to put more effort into breathing, which results in fatigue of the respiratory muscles and may lead to ventilatory failure. Post-cardiac surgery diaphragmatic palsy usually tends to be unilateral but rarely may be bilateral with consequent ventilatory failure. While the overall incidence and prevalence of diaphragmatic paralysis are variable due to the wide variety of underlying causes, symptomatic patients experience a marked decline in their quality of life. Different studies have concluded that exercise tolerance is greatly diminished with unilateral diaphragm paralysis if obesity is a comorbidity. An otherwise healthy patient may be able to compensate for the hemidiaphragm paralysis with the proper functioning hemidiaphragm and the assistance of accessory muscles.
Conservative Treatment Options
For patients with diaphragm paralysis, conservative treatment options can help manage symptoms and improve respiratory function. These non-invasive approaches may be recommended before considering surgical interventions.
Respiratory therapy and exercises
Pulmonary rehabilitation is a comprehensive program designed to improve the physical and psychological well-being of individuals with chronic respiratory conditions . It encompasses a multidisciplinary approach, combining exercise training, breathing techniques, education, and psychological support to help patients better manage their lung conditions and enhance their overall quality of life .
Key components of a pulmonary rehabilitation program include personalized exercise training, breathing exercises, nutritional counseling, psychological counseling, and respiratory therapies . These interventions aim to improve lung function, increase exercise tolerance, reduce symptoms, and enhance overall quality of life .
Assistive breathing devices
In some cases, patients with diaphragm paralysis may require the use of assistive breathing devices or mechanical ventilators . These devices can help support breathing and alleviate respiratory distress.
One specific option is diaphragmatic pacing, a minimally invasive procedure that artificially stimulates the diaphragm to contract, enabling patients to breathe naturally without the need for a ventilator . This approach can potentially reduce or eliminate the patient’s dependence on mechanical ventilation, particularly in cases of spinal cord injury or neuromuscular illnesses .
Medications
While medications may not directly treat diaphragm paralysis, they can be used to manage associated symptoms or underlying conditions . For example, bronchodilators may be prescribed to improve airflow and alleviate breathing difficulties, while corticosteroids can help reduce inflammation in the respiratory system.
It’s important to note that conservative treatment options are often used in conjunction with one another, and the specific approach will depend on the individual patient’s needs, the severity of their condition, and the underlying cause of their diaphragm paralysis.
Surgical Treatment in Delhi
Diaphragm plication
Diaphragmatic plication is a surgical procedure that aims to restore the functionality of a paralysed diaphragm. During the surgery, the diaphragm muscle is repositioned and tightened to improve its ability to contract and expand. This procedure can help alleviate breathing difficulties and improve overall lung function.
Diaphragmatic plication is typically performed using minimally invasive techniques, such as laparoscopy or thoracoscopy, resulting in smaller incisions and faster recovery times. Before undergoing diaphragmatic plication surgery, it is essential to be well-prepared both physically and mentally. Dr Pallavi Purwar will provide you with specific instructions to follow, which may include dietary restrictions, cessation of certain medications, and preoperative tests.
During the diaphragmatic plication surgery, you will be placed under general anesthesia to ensure your comfort throughout the procedure. The surgery is usually done by VATS (Thoracoscopy) or Robotic approach. A small incisions is required to insert a laparoscope or thoracoscope to visualise the diaphragm. The weakened muscle will be repositioned and sutured to strengthen its function. Recovery after diaphragmatic plication surgery varies for each individual. You will be encouraged to start moving and walking as soon as possible to prevent complications such as blood clots and to aid in the recovery process. Physical therapy may be recommended to help strengthen the diaphragm muscle and improve lung function.
Nerve grafting and pacing
Nerve grafts are used if a patient suffers from a nerve injury which leads to total loss of muscle function or feeling. A nerve graft is a surgical procedure that replaces or bridges a damaged part of the nerve by a segment of an unrelated nerve.
Phrenic nerve pacing is an option for patients with diaphragmatic paralysis who do not suffer from denervation of the diaphragm. This pacemaker stimulates the phrenic nerve to cause the diaphragm to contract as it would physiologically. Studies are showing promising results for diaphragmatic pacing. One study of 27 patients resulted in improvement in 81 percent of patients, four of which were able to be weaned off a ventilator.
Choosing the right surgical approach
Dr Pallavi Purwar offers surgical interventions for diaphragm paralysis, including diaphragmatic plication, nerve grafting, and phrenic nerve pacing. The cost of these procedures can vary depending on the patient condition and the specific approach chosen.
The choice of surgical approach will depend on various factors, including the underlying cause of diaphragm paralysis, the severity of the condition, and the patient’s overall health status. It is crucial to consult Dr. Pallavi Purwar as your surgeon or as second opinion in Delhi to determine the most appropriate surgical intervention and ensure the best possible outcome.
Conclusion
Diaphragm paralysis treatment in Delhi offers a range of options to address this challenging condition. From conservative approaches like respiratory therapy and assistive devices to surgical interventions such as diaphragm plication and nerve grafting, patients have access to comprehensive care. These treatments have an impact on improving breathing function and enhancing overall quality of life for those affected by diaphragm paralysis.
Choosing the right treatment approach depends on the individual’s specific situation, the underlying cause of the paralysis, and the severity of symptoms. To make informed decisions, it’s crucial for patients to work closely with Dr Pallavi to understand the underlying cause and preferred treatment option. With ongoing advancements in medical technology and surgical techniques, there’s hope for better outcomes and improved management of diaphragm paralysis in the future.
About Dr. Pallavi Purwar
- Best Chest Surgery in Delhi, India
- The best chest surgical care using state-of-the-art technology in New Delhi.
- Specialities: Lung cancer, chest wall tumors, thymoma, tracheal stenosis, aspergillosis, multidrug-resistant tuberculosis, post-tuberculosis sequelae, tuberculosis (TB) treatment, and various chest cancer surgeries.
Do Not Ignore the Symptoms
- Unexplained weight loss
- Shortness of breath
- Chest pain
- Blood in cough
- Fatigue
- Recurrence of fever
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Achievements
- 10+ Years of Experience
- Robotic Surgery: State-of-the-art technology
- VATS: Video-assisted thoracic surgery – Keyhole surgery
- Chest Surgery: Various benign and malignant diseases of lungs
- TB Surgery: Surgical treatment of complications of pulmonary tuberculosis
Why Choose Dr. Pallavi Purwar
- Specialised Expertise
- Patient-Centered Approach
- Comprehensive Care
- Highly Experienced
- Better Patient Outcomes
Contact Information
- Email: [email protected]
- Phone: +91 99100 81862