Experience of Supraclavicular Exploration and Decompression for Treatment of Thoracic Outlet Syndrome

McCarthy, Matthew; Varty, K.; London, N. J. M.; Bell, P. R.

doi:10.1007/s100169900256

Cited by 27 publications

(30 citation statements)

References 28 publications

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“…Cervical ribs are more common in females than males, in a ratio of 2:1, and are asymptomatic in 90% of cases [10]. In TOS adult patients the incidence of cervical ribs ranges from 22 to 65% [1,10,11,12,13,14]. Complete cervical rib, as identified in our study, is present in 1.4% of normal children [9] and in 0.5–1% of the general population [15].…”

Section: Discussionmentioning

confidence: 99%

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Cervical Rib Fracture: An Unusual Etiology of Thoracic Outlet Syndrome in a Child

Martins

Siqueira

2007

Pediatr Neurosurg

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Thoracic outlet syndrome in children is an extremely rare disorder. Only 5 previous reports were presented in the literature with a description of thoracic outlet syndrome in 8 children. In these cases, the diagnosis of a cervical rib was common. We describe a case of neurogenic thoracic outlet syndrome in a 9-year-old patient where the initial symptoms occurred 2 months after a fall. Clinically, the patient developed progressive pain, numbness and tingling along the inner surface of the left forearm and in the palmar surface of the fourth finger and lateral aspect of the fifth finger. A plain radiography showed a cervical rib fracture and an electrophysiologic study suggested the presence of left lower brachial plexus neuropathy. Her fractured cervical rib was resected through a supraclavicular approach. Her symptoms resolved completely in the postoperative period. Although very rare one should keep in mind the possibility of thoracic outlet syndrome in children, especially with a history of trauma over the shoulder girdle presenting with a cervical rib and a lower brachial plexopathy.

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Section: Discussionmentioning

confidence: 99%

“…It is generally accepted that thoracic outlet syndrome (TOS) occurs when there is compression of the neurovascular structures at some point between the base of the neck and the inferior border of the axilla [1]. TOS often develops during the 3rd or 4th decade and is more common in females than males.…”

Section: Introductionmentioning

confidence: 99%

Cervical Rib Fracture: An Unusual Etiology of Thoracic Outlet Syndrome in a Child

Martins

Siqueira

2007

Pediatr Neurosurg

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“…Transaxillary first rib resection and supraclavicular scalenectomy are commonly used for the surgical treatment of TOS. [1][2][3]6,8,17) Transaxillary first rib resection has been used to treat upper plexus TOS. 18,20) Supraclavicular scalenectomy was performed in 93 patients with upper plexus TOS but in only six patients as the primary operation.…”

Section: Discussionmentioning

confidence: 99%

Upper Plexus Thoracic Outlet Syndrome. Case Report.

Matsuyama

Okuchi

Goda³

2002

Neurol. Med. Chir.(Tokyo)

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A 47-year-old right-handed female became aware of proximal ache and muscle weakness in the right shoulder and elbow in 1997. Atrophy of the right biceps muscle was recognized and the right deltoid, triceps, supraspinatus, and infraspinatus muscles were weak. The Morley test and elevated arm stress test were positive. Neurolysis of the brachial plexus and anterior scalenectomy were performed via a right supraclavicular approach. An abnormal fibromuscular band was identified passing between the upper and middle trunks and constricting the middle trunk. Another scalene muscle anomaly was found passing between the C-5 and C-6 nerve roots and connecting the anterior and middle scalene muscles. These muscles were resected, and thorough neurolysis was performed around all nerves and the trunks. Postoperatively, all symptoms completely resolved and the patient was discharged 5 days after surgery. Thoracic outlet syndrome (TOS) manifests as symptoms of lower cervical nerve involvements with hypesthesia and paresthesia. However, upper plexus TOS manifests as symptoms due to the involvement of the C-5 to C-7 nerve roots, and is relatively rare. Transaxillary first rib resection is performed as the primary operation for TOS, but supraclavicular scalenectomy is effective for upper plexus TOS.

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“…One author reported a complication rate of 8%., a Horner's syndrome, supraclavicular hematoma and a pneumothorax, no reference was made to iatrogenic second rib resection [5] .…”

Section: Illustrative Casementioning

confidence: 99%

Second Rib Resection a Rare Complication of Thoracic Outlet Surgery Recommendations for Prevention

O-Yurvati¹

2017

IJCC

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Experience of Supraclavicular Exploration and Decompression for Treatment of Thoracic Outlet Syndrome

Cited by 27 publications

References 28 publications

Cervical Rib Fracture: An Unusual Etiology of Thoracic Outlet Syndrome in a Child

Cervical Rib Fracture: An Unusual Etiology of Thoracic Outlet Syndrome in a Child

Upper Plexus Thoracic Outlet Syndrome. Case Report.

Second Rib Resection a Rare Complication of Thoracic Outlet Surgery Recommendations for Prevention

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