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March 20, 1926

RADICAL PHRENICOTOMY FOR PULMONARY TUBERCULOSIS

Author Affiliations

Major, Medical Corps, United States Army DENVER
From the Fitzsimons General Hospital.

JAMA. 1926;86(12):811-813. doi:10.1001/jama.1926.02670380001001
Abstract

Phrenicotomy, or simple division of the phrenic nerve in the cervical region, was first suggested by Steurtz for lower lobe tuberculosis in 1911, but little interest was manifested in the therapy of this procedure till Goetze1 and Felix2 reported (early in 1922) the results of their extensive research work on phrenicotomy. The latter authorities showed that the hemidiaphragm does not remain completely paralyzed after simple section of the phrenic nerve in from 25 to 30 per cent of cases, owing to failure of interception of an accessory phrenic nerve which joins the main nerve below the first rib, and each devised a "radical phrenicotomy," which would also interrupt this accessory nerve, as well as any connecting cervical sympathetic fibers of the phrenic nerve, with resultant permanent paralysis of half the diaphragm.

Goetze isolates the phrenic nerve in the neck down to the inferior cervical ganglion, where he removes

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