From the Research
A ganglion that compresses the phrenic nerve and paralyzes the vocal cords is most likely a mediastinal ganglion, specifically one located in the superior mediastinum, as supported by the anatomy and clinical presentations described in various studies 1, 2, 3, 4. The phrenic nerve and recurrent laryngeal nerves are in close proximity in the thoracic inlet, making them susceptible to compression by pathologically enlarged lymphatic chains, such as those seen in lung cancer or lymphoma.
- The clinical presentation of patients with such compression typically includes hoarseness, difficulty breathing, and possibly hiccups or respiratory compromise.
- Diagnosis requires imaging studies, such as CT or MRI of the chest, along with possible bronchoscopy and biopsy, as mentioned in studies 2, 4.
- Treatment depends on the underlying cause but may include surgical removal of the ganglion, radiation therapy for malignancies, or corticosteroids for inflammatory conditions, as discussed in 5, 4.
- The anatomical basis for this dual compression is the close proximity of these neural structures in the thoracic inlet, where both the phrenic nerve and recurrent laryngeal nerves run near lymphatic chains that can become pathologically enlarged, as described in 1, 2.
- It's worth noting that phrenic nerve injury can result in paralysis of the diaphragm muscle, leading to exertional dyspnea, orthopnea, and sleep-disordered breathing, and treatment options include phrenic nerve reconstruction surgery, as discussed in 4.