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https://www.readbyqxmd.com/read/29336398/concomitant-neurogenic-and-vascular-thoracic-outlet-syndrome-due-to-multiple-exostoses
#1
Hosseinali Abdolrazaghi, Azade Riyahi, Morteza Taghavi, Pezhman Farshidmehr, Abolfazl Mohammadbeigi
We report a rare case of multiple hereditary exostosis where patient presented with bilateral base of neck exostoses with concurrent compression of brachial plexus and subclavian artery and vein. The patient was a young 26-year-old woman with chief complaints of pain in the left upper extremity, paresthesia in the left ring and little finger, and weakness in hand movement and grip. On referral, history, physical examination, radiological imaging, and electrodiagnostic tests evaluated the patient. Due to severe pain and disability in performing routine activities, surgical intervention was necessary...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29329197/long-term-functional-outcome-of-surgical-treatment-for-thoracic-outlet-syndrome
#2
Jesse Peek, Cornelis G Vos, Çağdas Ünlü, Michiel A Schreve, Rob H W van de Mortel, Jean-Paul P M de Vries
First rib resection for thoracic outlet syndrome (TOS) is clinically successful and safe in most patients. However, long-term functional outcomes are still insufficiently known. Long-term functional outcome was assessed using a validated questionnaire. A multicenter retrospective cohort study including all patients who underwent operations for TOS from January 2005 until December 2016. Clinical records were reviewed and the long-term functional outcome was assessed by the 11-item version of the Disability of the Arm, Shoulder, and Hand (QuickDASH) questionnaire...
January 12, 2018: Diagnostics
https://www.readbyqxmd.com/read/29301465/outcomes-following-operative-management-of-thoracic-outlet-syndrome-in-the-pediatric-patients
#3
Jesus M Matos, Lorena Gonzalez, Elias Kfoury, Angela Echeverria, Carlos F Bechara, Peter H Lin
Objectives Thoracic outlet syndrome, a condition commonly reported in adults, occurs infrequently in the pediatric population. The objective of this study was to assess the outcome of surgical interventions of thoracic outlet syndrome in pediatric patients. Methods Clinical records of all pediatric patients with thoracic outlet syndrome who underwent operative repair from 2002 to 2015 in a tertiary pediatric hospital were reviewed. Pertinent clinical variables and treatment outcomes were analyzed. Results Sixty-eight patients underwent a total of 72 thoracic outlet syndrome operations (mean age 15...
January 1, 2018: Vascular
https://www.readbyqxmd.com/read/29289365/thoracoscopic-versus-transaxillary-approach-to-first-rib-resection-in-thoracic-outlet-syndrome
#4
Henrik Nuutinen, Teemu Riekkinen, Voitto Aittola, Kimmo Mäkinen, Jussi M Kärkkäinen
BACKGROUND: This study assessed the feasibility of fully endoscopic thoracoscopic first rib resection (FRR) in the treatment of neurogenic thoracic outlet syndrome by comparing early outcomes of the thoracoscopic technique against the traditional transaxillary FRR. METHODS: Between 2009 and 2016, 60 consecutive FRRs were performed on 47 patients with neurogenic thoracic outlet syndrome (13 bilateral procedures). The first 30 procedures were performed using the traditional transaxillary technique, and the novel thoracoscopic technique was used in the next 30 operations with the same indications for operative repair...
December 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29241462/-neurogenic-thoracic-outlet-syndrome
#5
J A W Teijink, N Pesser, R van Grinsven, H van Suijlekom, M R H M van Sambeek, B F L van Nuenen
Neurogenic thoracic outlet syndrome (nTOS) is a type of thoracic outlet syndrome (TOS) where compression of the brachial plexus is responsible for development of upper-extremity, head and neck symptoms. We present a 16-year-old and a 34-year-old patient with nTOS. Diagnosis in both cases was done by following the recently published reporting standards for (n)TOS. After this multidisciplinary diagnostic work-up we performed a transaxillary thoracic outlet decompression (TOD). Due to lack of literature, difficult nomenclature and complexity of diagnosis and treatment, diagnosis of nTOS is often delayed...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29203316/cervical-rib-prevalence-and-its-association-with-thoracic-outlet-syndrome-a-meta-analysis-of-141-studies-with-surgical-considerations
#6
Brandon Michael Henry, Jens Vikse, Beatrice Sanna, Dominik Taterra, Martyna Gomulska, Przemysław A Pękala, R Shane Tubbs, Krzysztof A Tomaszewski
BACKGROUND: Cervical ribs (CR) are supernumerary ribs that arise from the seventh cervical vertebra. In the presence of CR, the boundaries of the interscalene triangle can be further constricted and result in neurovascular compression and thoracic outlet syndrome (TOS). The aim of our study was to provide a comprehensive evidence-based assessment of CR prevalence and their association with TOS as well as surgical approach to excision of CR and surgical patients' characteristics. METHODS: A thorough search of major electronic databases was conducted to identify any relevant studies...
December 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29125442/long-term-outcomes-after-surgical-treatment-of-pediatric-neurogenic-thoracic-outlet-syndrome
#7
Jennifer Hong, Jared M Pisapia, Zarina S Ali, Austin J Heuer, Erin Alexander, Gregory G Heuer, Eric L Zager
OBJECTIVE Neurogenic thoracic outlet syndrome (nTOS) is an uncommon compression syndrome of the brachial plexus that presents with pain, sensory changes, and motor weakness in the affected limb. The authors reviewed the clinical presentations and outcomes in their series of pediatric patients with surgically treated nTOS over a 6-year period. METHODS Cases of nTOS in patients age 18 years or younger were extracted for analysis from a prospective database of peripheral nerve operations. Baseline patient characteristics, imaging and neurophysiological data, operative findings, and outcomes and complications were assessed...
November 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29106657/posterior-upper-rib-excision-for-neurogenic-thoracic-outlet-syndrome-feasibility-and-early-outcomes
#8
Kamran Aghayev, Ozcan Ciklatekerlio
BACKGROUND: There are several surgical treatment options for neurogenic thoracic outlet syndrome (n-TOS). However, the first rib has been shown to be the common denominator of all TOS forms and the degree of its resection has been shown to correlate with the long-term success. OBJECTIVE: To demonstrate the feasibility of posterior upper rib excision (PURE) and report early outcomes. METHODS: Nine patients presented with signs and symptoms of n-TOS...
July 6, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28970979/all-endoscopic-brachial-plexus-complete-neurolysis-for-idiopathic-neurogenic-thoracic-outlet-syndrome-surgical-technique
#9
Thibault Lafosse, Malo Le Hanneur, Laurent Lafosse
Neurogenic thoracic outlet syndrome is caused by a neurologic compression of the brachial plexus before it reaches the arm. Three anatomic areas are common locations for such an entrapment because of their congenital and/or acquired tightness: the interscalene triangle, the costoclavicular space, and the retropectoralis minor space. Because the compression level usually remains unknown, the treatment is still controversial and most teams focus on only one potential site. We propose an all-endoscopic technique of complete brachial plexus neurolysis that can be divided into three parts, one for each entrapment area...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28943009/midterm-and-long-term-follow-up-in-competitive-athletes-undergoing-thoracic-outlet-decompression-for-neurogenic-thoracic-outlet-syndrome
#10
William Shutze, Brad Richardson, Ryan Shutze, Kimberly Tran, Allen Dao, Gerald O Ogola, Allan Young, Greg Pearl
BACKGROUND: Neurogenic thoracic outlet syndrome (NTOS) results from compression of the brachial plexus by the clavicle, first rib, and scalene muscles and may develop secondary to repetitive motion of the upper extremity. Athletes routinely perform repetitive motions, and sports requiring significant arm and shoulder use may put the participant at increased risk for NTOS. Competitive athletes who develop NTOS may require first rib resection and scalenectomy (FRRS) for symptomatic relief...
December 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28928918/arterial-thoracic-outlet-syndrome-secondary-to-hypertrophy-of-the-anterior-scalene-muscle
#11
Erion Qaja, Sara Honari, Robert Rhee
Thoracic outlet syndrome (TOS) was first introduced in literature by Peet et al. in 1956. Since then is has been studied extensively and subcategorized into at least four closely related syndrome. Neurogenic TOS due to the compression of brachial plexus, arterial TOS in cases of compression of the subclavian artery, venous TOS in cases of compression of the subclavian vein, and non-specific type of TOS. Neurogenic TOS is by far the most common consisting of 95% of the cases, followed by venous and lastly arterial...
August 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28845317/arterial-thoracic-outlet-syndrome-treated-successfully-with-totally-endoscopic-first-rib-resection
#12
Sofoklis Mitsos, Davide Patrini, Sara Velo, Achilleas Antonopoulos, Martin Hayward, Robert S George, David Lawrence, Nikolaos Panagiotopoulos
Thoracic outlet syndrome (TOS) is a constellation of signs and symptoms caused by compression of the neurovascular structures in the thoracic outlet. TOS may be classified as either neurogenic TOS (NTOS) or vascular TOS: venous TOS (VTOS) or arterial TOS (ATOS), depending on the specific structure being affected. The basis for the surgical treatment of TOS is resection of the first rib, and it may be combined with scalenectomy or cervical rib resection. Herein, we describe a case of arterial thoracic outlet syndrome which was successfully treated with totally endoscopic video-assisted thoracoscopic surgery (VATS) first rib resection...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28840002/video-assisted-thoracoscopic-surgery-for-intrathoracic-first-rib-resection-in-thoracic-outlet-syndrome
#13
Jinwook Hwang, Byung-Ju Min, Won-Min Jo, Jae Seung Shin
BACKGROUND: First rib resection is a surgical treatment for decompressing the neurovascular structures in thoracic outlet syndrome (TOS). Historically, extrathoracic approaches have used a posterior, supraclavicular, or transaxillary incision to remove the first rib. In this report, we demonstrate video-assisted thoracoscopic surgery for intrathoracic first rib resection (VATS-IFRR). METHODS: Between 2009 and 2014, eight patients underwent VATS-IFRR for TOS. Surgery was performed through two 5-mm ports and one 10-mm port...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28735950/associations-between-clinical-diagnostic-criteria-and-pretreatment-patient-reported-outcomes-measures-in-a-prospective-observational-cohort-of-patients-with-neurogenic-thoracic-outlet-syndrome
#14
Joshua Balderman, Katherine Holzem, Beverly J Field, Michael M Bottros, Ahmmad A Abuirqeba, Chandu Vemuri, Robert W Thompson
OBJECTIVE: Neurogenic thoracic outlet syndrome (NTOS) is caused by dynamic compression of the brachial plexus at the level of the supraclavicular scalene triangle or the subcoracoid (pectoralis minor) space, or both. The purpose of this study was to characterize relationships between 14 clinical diagnostic criteria (CDC) and seven pretreatment patient-reported outcomes measures (PROMs) in a prospective cohort of patients with NTOS. METHODS: There were 183 new patient referrals between July 1 and December 31, 2015, with 150 (82%) meeting an established set of predefined CDC for NTOS...
August 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28677632/ultrasonographic-diagnosis-of-thoracic-outlet-syndrome-secondary-to-brachial-plexus-piercing-variation
#15
Vanessa Leonhard, Gregory Caldwell, Mei Goh, Sean Reeder, Heather F Smith
Structural variations of the thoracic outlet create a unique risk for neurogenic thoracic outlet syndrome (nTOS) that is difficult to diagnose clinically. Common anatomical variations in brachial plexus (BP) branching were recently discovered in which portions of the proximal plexus pierce the anterior scalene. This results in possible impingement of BP nerves within the muscle belly and, therefore, predisposition for nTOS. We hypothesized that some cases of disputed nTOS result from these BP branching variants...
July 4, 2017: Diagnostics
https://www.readbyqxmd.com/read/28644402/choosing-surgery-for-neurogenic-tos-the-roles-of-physical-exam-physical-therapy-and-imaging
#16
REVIEW
David P Kuwayama, Jason R Lund, Charles O Brantigan, Natalia O Glebova
Neurogenic thoracic outlet syndrome (nTOS) is characterized by arm and hand pain, paresthesias, and sometimes weakness resulting from compression of the brachial plexus within the thoracic outlet. While it is the most common subtype of TOS, nTOS can be difficult to diagnose. Furthermore, patient selection for surgical treatment can be challenging as symptoms may be vague and ambiguous, and diagnostic studies may be equivocal. Herein, we describe some approaches to aid in identifying patients who would be expected to benefit from surgical intervention for nTOS...
June 23, 2017: Diagnostics
https://www.readbyqxmd.com/read/28616159/thoracic-outlet-syndrome-as-a-consequence-of-isolated-atraumatic-first-rib-fracture
#17
Aleem K Mirza, Audra A Duncan
Neurogenic thoracic outlet syndrome (nTOS) resulting from an isolated first rib fracture is extremely infrequent. We report a case of performance limiting nTOS in a college athlete who was initially evaluated and treated for upper extremity ligamentous injury with only transient improvement. Subsequent noninvasive studies were consistent with TOS physiology and MRA showed a large hypertrophic callus on the first rib adjacent to the brachial plexus. With continued athletic limitations and radiographic findings consistent with TOS, surgical decompression was performed resulting in resolution of symptoms...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28604581/vascular-tos-creating-a-protocol-and-sticking-to-it
#18
REVIEW
Meena Archie, David Rigberg
Thoracic Outlet Syndrome (TOS) describes a set of disorders that arise from compression of the neurovascular structures that exit the thorax and enter the upper extremity. This can present as one of three subtypes: neurogenic, venous, or arterial. The objective of this section is to outline our current practice at a single, high-volume institution for venous and arterial TOS. VTOS: Patients who present within two weeks of acute deep vein thrombosis (DVT) are treated with anticoagulation, venography, and thrombolysis...
June 10, 2017: Diagnostics
https://www.readbyqxmd.com/read/28579292/current-practice-of-thoracic-outlet-decompression-surgery-in-the-united-states
#19
Elena K Rinehardt, John E Scarborough, Kyla M Bennett
BACKGROUND: Thoracic outlet syndrome (TOS) and its management are relatively controversial topics. Most of the literature reporting the outcomes of surgical decompression for TOS derives from single-center experiences. The objective of our study was to describe the current state of TOS surgery among hospitals that participate in the American College of Surgeons National Surgical Quality Improvement Program database. METHODS: Our study sample consisted of patients from the 2005 to 2014 American College of Surgeons National Surgical Quality Improvement Program database who underwent first or cervical rib resection as their index procedure and whose constellation of diagnosis and procedure codes identified them as having neurogenic, arterial, or venous TOS...
September 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28555024/new-diagnostic-and-treatment-modalities-for-neurogenic-thoracic-outlet-syndrome
#20
REVIEW
M Libby Weaver, Ying Wei Lum
Neurogenic thoracic outlet syndrome is a widely recognized, yet controversial, syndrome. The lack of specific objective diagnostic modalities makes diagnosis difficult. This is compounded by a lack of agreed upon definitive criteria to confirm diagnosis. Recent efforts have been made to more clearly define a set of diagnostic criteria that will bring consistency to the diagnosis of neurogenic thoracic syndrome. Additionally, advancements have been made in the quality and techniques of various imaging modalities that may aid in providing more accurate diagnoses...
May 27, 2017: Diagnostics
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