“He feels his breathing is back to normal”: Diaphragm Position and Patient-Reported Outcomes Following Phrenic Nerve Reconstruction for Diaphragm Paralysis.

<bold>Objective:</bold> To investigate diaphragm position and patient-reported outcomes following phrenic nerve reconstruction for diaphragm paralysis. <bold>Method:</bold> A retrospective chart review was conducted on 50 randomly selected patients with symptomatic diaphragm paralysis who underwent phrenic nerve reconstruction, from a larger cohort of 411 patients treated between 2018 and 2023. The sample size was meticulously chosen to attain 90% power in detecting medium to large effect sizes, with patients selected using systematic random sampling. PROs were obtained from a review of chart notes documenting interactions between the clinical care team and patients. Thoracic radiographic imaging obtained 30 days before and 12 months after surgery were analyzed to assess changes in diaphragm position post-intervention. Diaphragm position was referenced to the nearest rib interspace. <bold>Results:</bold> A paired sample t-test showed a significant depression in diaphragm position postoperatively (M=8.72, SE=.13) compared to baseline measurements (M=7.35, SE=.14), t (37) = -11.66, p<.05, r =.88. Furthermore, a content analysis of chart notes revealed the following PROs: 91% experienced improved respiratory function, 88% reported better sleep quality, and 72% noted increased physical and social functioning. <bold>Conclusion:</bold> The findings endorse phrenic nerve reconstruction as an effective intervention for diaphragm paralysis, showcasing improved diaphragm position and positive PROs. Further research is warranted to address methodological limitations and expand upon these findings.