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Trans-Cervical Approach To The Thoracic Outlet Syndrome

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Thoracic outlet syndrome is caused by compression of the neurovascular structures within the thoracic outlet leading to a collection of symptoms in the upper limb and shoulder. Identification of the causative factor is essential and thorough clinical examination using specific manoeuvres can aid in the diagnosis of this syndrome. Cervical rib is one of the causes for thoracic outlet syndrome and this manuscript will discuss the thoracic outlet syndrome, cervical rib, incidence, clinical presentation, diagnosis and management including surgical approaches with a focus on transcervical approach.

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References

  1. Jones MR, Prabhakar A, Viswanath O, Urits I, Green JB, Kendrick JB, Brunk AJ, Eng MR, Orhurhu V, Cornett EM, Kaye AD (2019) Thoracic outlet syndrome: a Comprehensive Review of Pathophysiology, diagnosis, and treatment. Pain Ther 8(1):5–18

    Article  PubMed  PubMed Central  Google Scholar 

  2. Huang JH, Zager EL (2004) Thoracic outlet syndrome. Neurosurgery 55:897–902 Discussion 902–893

    Article  PubMed  Google Scholar 

  3. Sanders RJ, Hammond SL, Rao NM (2008) Thoracic outlet syndrome: a review. Neurologist 14:365–373

    Article  PubMed  Google Scholar 

  4. Renae Fisher J, Simon Chap. 22 - Thoracic Outlet Syndrome, Editor(s): Mitchell K. Freedman, Jeffrey A. Gehret, George W. Young, Leonard B. Kamen, Challenging Neuropathic Pain Syndromes, Elsevier, 2018,Pages 187–195,ISBN 9780323485661,https://doi.org/10.1016/B978-0-323-48566-1.00022-X

  5. Atasoy E (1996) Thoracic outlet compression syndrome. Orthop Clin North Am 27(2):265–303 PMID: 8614579

    Article  MathSciNet  CAS  PubMed  Google Scholar 

  6. Nichols AW (2009) September. Diagnosis and Management of Thoracic Outlet Syndrome. Current Sports Medicine Reports 8(5):p 240–249, | https://doi.org/10.1249/JSR.0b013e3181b8556d

  7. Eric J, Panther CD, Reintgen RJ, Cueto KA, Hao H, Chim JJ, King Thoracic outlet syndrome: a review. J Shoulder Elb Surg Volume 31, Issue 11,2022,Pages e545-e561,ISSN 1058–2746,https://doi.org/10.1016/j.jse.2022.06.026

  8. Farquharson B, Collis J, Jaskani S, Bergman H, Andrews B (2023) 17 Years’ experience of surgical management of thoracic outlet syndrome at a district general hospital. Ann R Coll Surg Engl. Feb 13. https://doi.org/10.1308/rcsann.2023.0002. Epub ahead of print. PMID: 36779445

  9. Thomas Heye MR, Timbang L, Richter GG (2022) Congenital cervical rib causing thoracic outlet syndrome. J Pediatric Surgery Case Rep 76:102126. ISSN 2213–5766. https://doi.org/10.1016/j.epsc.2021.102126.

  10. 10.Jérôme Gillard, Pérez-Cousin M, Hachulla Éric, Remy J, Hurtevent J-F, Vinckier L, Thévenon André Bernard Duquesnoy,diagnosing thoracic outlet syndrome: contribution of provocative tests, ultrasonography, electrophysiology, and helical computed tomography in 48 patients,joint bone spine, 68, Issue 5,2001,Pages 416–424,ISSN 1297-319https://doi.org/10.1016/S1297-319X(01)00298-6

  11. .[Guideline] Expert Panels on Vascular Imaging, Imaging T, Imaging N, Zurkiya O, Ganguli S, Kalva SP et al (2020 May) ACR appropriateness Criteria® thoracic outlet syndrome. J Am Coll Radiol 17(5S):S323–S334 [QxMD MEDLINE Link]. [Full Text]

  12. Nord KM, Kapoor P, Fisher J, Thomas G, Sundaram A, Scott K et al False positive rate of thoracic outlet syndrome diagnostic maneuvers. Electromyogr Clin Neurophysiol 2008 Mar 48(2):67–74. [QxMD MEDLINE Link]

  13. Costelloe CM, Akers DL, Lang EK (2001 Oct) Thoracic outlet syndrome: case report and review. J La State Med Soc 153(10):504–510 [QxMD MEDLINE Link]

  14. Aghayev A, Rybicki FJ (2015 May) State-of-the-art magnetic resonance imaging in vascular thoracic outlet syndrome. Magn Reson Imaging Clin N Am 23(2):309–320 [QxMD MEDLINE Link]

  15. Matsusaka Y, Nakahara T, Iwabuchi Y, Kameyama M, Murakami K (2015 Dec) Sternal Uptake of 99mTc-MAA in thoracic outlet syndrome. Clin Nucl Med 40(12):971–972 [QxMD MEDLINE Link]

  16. Marine L, Valdes F, Mertens R, Kramer A, Bergoeing M, Urbina J (2013 Nov) Arterial thoracic outlet syndrome: a 32-year experience. Ann Vasc Surg 27(8):1007–1013 [QxMD MEDLINE Link]

  17. Povlsen S, Povlsen B (2018 Mar) Diagnosing thoracic outlet syndrome: current approaches and future directions. Diagnostics (Basel), vol 20. [QxMD MEDLINE Link], 1

  18. Hussain MA, Aljabri B, Al-Omran M Vascular thoracic outlet syndrome. Semin Thorac Cardiovasc Surg 2016 Spring. 28 (1):151–157. [QxMD MEDLINE Link]. [Full Text].

  19. The Epidemiological, Morphological, and Clinical Aspects of the Cervical Ribs in Humans - PMC [Internet]. [cited 2024 Jan 1]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5126392/

  20. Wellik DM Chapter 9 Hox Genes and Vertebrate Axial Pattern. In: Current Topics in Developmental Biology [Internet]. Elsevier; 2009 [cited 2024 Jan 1]. p. 257–78. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0070215309880095

  21. Fliegel BE, Menezes RG, Anatomy, Thorax CR [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541001/

  22. Hussain MA, Aljabri B, Al-Omran M (2016) Vascular thoracic outlet syndrome. Semin Thorac Cardiovasc Surg 28:151–157 [PubMed] [Google Scholar]

    Article  PubMed  Google Scholar 

  23. Sanders RJ, Annest SJ (2015) Technique of supraclavicular decompression for neurogenic thoracic outlet syndrome. J Vasc Surg 61:821–825 [PubMed] [Google Scholar]

    Article  PubMed  Google Scholar 

  24. Caputo FJ, Wittenberg AM, Vemuri C, Driskill MR, Earley JA, Rastogi R (2013) Supraclavicular decompression for neurogenic thoracic outlet syndrome in adolescent and adult populations. J Vasc Surg 57:149–157 [PubMed] [Google Scholar]

    Article  PubMed  Google Scholar 

  25. Sanders RJ, Hammond SL (2002) Management of cervical ribs and anomalous first ribs causing neurogenic thoracic outlet syndrome. J Vasc Surg 36:51–56 [PubMed] [Google Scholar]

    Article  PubMed  Google Scholar 

  26. Adson AW (1927) J.R Cervical rib: a method of anterior approach for relief of symptoms by division of the scalenus anticus. Ann Surg 85:839–857

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Thoracic Outlet Syndrome ImagingUpdated : Jun 27, 2023 Author: Meghal Antani, MD; Chief Editor: Kyung J Cho, MD, FACR, FSIR; https://emedicine.medscape.com/article/418670-overview?form=fpf

  28. Peek J, Vos CG Ünlü Ç.van, de Pavoordt H (2017) D.W.M. van den Akker P.J.,de Vries J.P.M Outcome of surgical treatment for thoracic outlet syndrome: systematic review and meta-analysis. Ann Vasc Surg ; 40: 303–326

  29. Yin ZG, Gong KT, Zhang J (2019) B.Outcomes of surgical management of neurogenic thoracic outlet syndrome: a systematic review and bayesian perspective. J Hand Surg Am 44:416 .e1-416.e17

    Article  Google Scholar 

  30. Surgical Approaches for Thoracic Outlet Syndrome: A Review of the LiteratureTaku Suzuki, MD, PhD,Hiroo Kimura, MD, PhD,Noboru Matsumura, MD, PhD,Takuji Iwamoto, MD, PhD

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Authors and Affiliations

  1. Department of Head and Neck Oncology, Apollo Cancer Center, Room no 1A, Film Nagar Jubilee Hills, Hyderabad, 500096, India

    Ankita Kushwaha, Umanath Nayak, Rahul Buggaveeti, Abhishek Budharapu, Aiswarya Vaidyanathan & Ashwini Munnangi

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  1. Ankita Kushwaha
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  2. Umanath Nayak
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  3. Rahul Buggaveeti
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Correspondence to Ashwini Munnangi.

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Kushwaha, A., Nayak, U., Buggaveeti, R. et al. Trans-Cervical Approach To The Thoracic Outlet Syndrome. Indian J Otolaryngol Head Neck Surg (2024). https://doi.org/10.1007/s12070-024-04597-9

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