I am curious if it is possible to have damage to the vagus nerve at the level of the diaphragm, as a result of surgery or from adhesions (compression of the nerve)? I have a spot in my upper abdomen which has been extremely sore and at one point, the pain shot right up to my throat. I'm having a decrease in my automatic breathing, it feels like the muscles along my airway aren't working, and my swallowing is beginning to be affected. Also, I sometimes have orthostatic hypotension. The thing I think that may be in common with all of these symptoms is the vagus nerve. But everything I read about vagus nerve damage is usually resulting from a problem in the neck area or brain. So what do you think about possible problems stemming from the other end? Would the dysfunction of the nerve start at the point of damage and over time continue to the other end? I remember this being the case when I had damage to the sciatic nerve. Also, when I had the pain right up my middle, there was a tightness like a string was being pulled, another reason I think perhaps there has been nerve irritation (either damage or compression). Looking forward to hearing if you think this is possible.
Thank you,
Reply: ----------------------
It is certainly possible to injure a nerve during surgery. The vagus nerve exits the brainstem through the jugular foramen of the skull and follows the carotid artery down to the esophagus where it courses along the esophagus through the diaphragm. The vast majority of inadvertent surgical injuries to the vagus nerve occur as the result of neck surgery, in particular carotid artery surgery or thyroid surgery. Injuries to the vagus nerve at the level of the neck typically result in hoarseness since a branch of the vagus nerve in the lower part of the neck innervates the vocal cords.
Vagotomies are surgical procedures whereby the vagus nerve is purposefully cut in the abdomen as an adjunctive surgical treatment for stomach ulcers. When the vagus nerve is cut where in abdominal surgery it will not result in hoarseness nor should it cause any other localized throat symptoms. Therefore, to answer your question, it is not probable that an injury to the vagus nerve occurring near the diaphragm would cause throat nor airway symptoms.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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