Recurrent neurogenic thoracic outlet syndrome

Computed tomography-guided reoperation for neurogenic thoracic outlet syndrome

“…Sanders et al 8 provided a more sobering review of their 134 operations for recurrent nTOS in 97 patients where long-term failures occurred after the second operation in 50% of patients, unless recurrence was thought to be related to trauma. Finally, more contemporary series from Lindgren et al, 9 Ambrad-Chalela, 10 Rochlin et al, 11 Gelabert et al, 12 and Likes et al 13 presented limited numbers of patients undergoing reoperation for recurrent nTOS with heterogeneous patient characteristics and presentations, further emphasizing the need for more objective markers of nTOS recurrence for standardization.…”

Supraclavicular Approach for Thoracic Outlet Syndrome

“…However, different publications suggest that this method alone results in a recurrence rate of approximately 20-30% in experienced hands [3,32,33]. Complications of this technique include superficial and deep infection, pneumothorax, vascular injuries, lymphatic duct injury, and neural injuries.…”

“…Ambrad-Chalela et al [3], using a supraclavicular approach for recurrent cases of TOS, reported on 20 cases that all (100%) had "excellent" or "good" results from repeat surgery to eliminate the underlying problems (removal of intact or residual rib, pectoralis minor tenotomy, brachial plexus neurolysis, or a combination of these). No complications were observed, and all patients were able to return to activities of daily living.…”

Exercise-Induced Scalenus Syndrome

“…13,18,19 Scalenus anticus syndrome involves the compression of the lower brachial plexus and/or the subclavian artery as they pass through the interscalene triangle. 4 The pressure is usually imposed by muscle hypertrophy. The ulnar side is involved in this syndrome, so symptoms of neuropathy most often involve numbness in the fourth and fifth fingers, the lateral side of the hand, and possibly the forearm, as well as decreased sensory appreciation of light touch or pinprick in the fifth digit.…”