Peripheral Nerve Surgery and ResearchReinnervation of the Diaphragm After Bilateral Phrenic Nerve Resection and Immediate Reconstruction Using a Contralateral Phrenic Nerve AutograftBrunetti, Beniamino MD, PhDa; Morelli Coppola, Marco MDa; Crucitti, Pierfilippo MDb; Spinelli, Francesco MDc; Stilo, Francesco MD, PhDc; Longo, Filippo MDb; Cortese, Livio MDd; Tenna, Stefania MD, PhD, FEBOPRASa; Persichetti, Paolo MD, PhD, FEBOPRASaAuthor Information From the aDepartment of Plastic, Reconstructive and Aesthetic Surgery bDepartment of Thoracic Surgery cDepartment of Vascular Surgery dDepartment of Geriatric Medicine, Campus Bio-Medico University, Rome, Italy. Received April 6, 2020, and accepted for publication, after revision July 10, 2020. Conflicts of interest and sources of funding: none declared. Reprints: Marco Morelli Coppola, MD, Department of Plastic, Reconstructive and Aesthetic Surgery Campus Bio-Medico University, Rome, Italy. E-mail: [email protected]. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.annalsplasticsurgery.com). Annals of Plastic Surgery: November 2020 - Volume 85 - Issue 5 - p 527-530 doi: 10.1097/SAP.0000000000002543 Buy SDC Metrics Abstract A patient affected by a voluminous synovial sarcoma of mediastinum received radical surgery, resulting in injury of both phrenic nerves. Because of the cancer location, reconstruction of the left phrenic nerve was not possible, so to prevent the patient's ventilator dependence, the right phrenic nerve was reconstructed via an autograft from the residual proximal stump of the contralateral one. In 3 months, the right hemidiaphragm function showed a full recovery, documented by ultrasonographic and radiographic assessment of diaphragmatic excursion, and the patient was weaned from mechanical ventilation. When a nerve autograft is indicated, the sural nerve still remains the criterion standard, because of the low morbidity of the donor site and ease of harvesting; however, in particular situations, such as in this unique case, the choice of an orthotopic graft may offer promising results. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.