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https://www.readbyqxmd.com/read/29783723/the-art-of-caring-in-the-treatment-of-thoracic-outlet-syndrome
#1
EDITORIAL
Julie Ann Freischlag
Those who diagnose and treat patients with thoracic outlet syndrome, especially those patientswith neurogenic thoracic outlet syndrome, have a practice, which needs to include many modalities todiagnose, treat, and intervene to improve their quality of life for the present and for the future.[...].
May 19, 2018: Diagnostics
https://www.readbyqxmd.com/read/29772332/outcomes-following-transaxillary-approach-to-cervical-and-first-rib-resection-for-neurogenic-thoracic-outlet-syndrome
#2
Arjun Jayaraj, Audra A Duncan, Manju Kalra, Thomas C Bower, Peter Gloviczki
OBJECTIVE: Cervical rib can often be symptomatic causing neurogenic thoracic outlet syndrome (nTOS). Surgical treatment involves rib resection through a supraclavicular, transaxillary or combined approach. We review outcomes of different approaches and describe our technique of transaxillary resection through a video. METHODS: Single center retrospective review of peri-operative and short-term outcomes in subjects undergoing cervical rib resection for nTOS between 1994 and 2013...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29752917/robotically-assisted-transthoracic-cervical-rib-resection
#3
Elke Wybaillie, Lieven Maene, Francis Cooreman, Roel Beelen
Several different approaches to perform surgical decompression of the thoracic outlet have been described. We report a unique case of robotically-assisted transthoracic cervical rib resection for neurogenic thoracic outlet syndrome. This minimally invasive technique offers delicate tissue manipulation under optimal visualization of the thoracic outlet structures. Hence, it promotes patient safety and complete surgical decompression.
May 9, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29705086/transaxillary-decompression-of-thoracic-outlet-syndrome-patients-presenting-with-cervical-ribs
#4
Hugh A Gelabert, David A Rigberg, Jessica B O'Connell, Sinan Jabori, Juan Carlos Jimenez, Steven Farley
OBJECTIVE: The transaxillary approach to thoracic outlet decompression in the presence of cervical ribs offers the advantage of less manipulation of the brachial plexus and associated nerves. This may result in reduced incidence of perioperative complications, such as nerve injuries. Our objective was to report contemporary data for a series of patients with thoracic outlet syndrome (TOS) and cervical ribs managed through a transaxillary approach. METHODS: We reviewed a prospectively maintained database for all consecutive patients who underwent surgery for TOS and who had a cervical rib...
April 25, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29652235/harvey-cushing-s-management-of-neurogenic-thoracic-outlet-syndrome
#5
Courtney Pendleton, Allan J Belzberg, Robert J Spinner, Alfredo Quinones-Hinojosa
Harvey Cushing is widely regarded as one of the forefathers of neurosurgery, and is primarily associated with his work on intracranial pathology. However, he had a clinical and academic interest in peripheral nerve surgery. Through the courtesy of the Alan Mason Chesney Medical Archives, the surgical records of the Johns Hopkins Hospital from 1896 to 1912 were reviewed. The records of a single patient undergoing brachial plexus exploration and cervical rib resection were selected for detailed review. The operative report and accompanying illustrations demonstrate Cushing's interest in adding approaches to the pathology of the brachial plexus to his operative armamentarium...
April 13, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29627065/after-a-motor-vehicle-accident-is-it-neurogenic-thoracic-outlet-syndrome-or-ulnar-entrapment-syndrome-how-to-make-the-correct-diagnosis
#6
A Ian Munro, G Duncan McPherson, Wr Eric Jamieson
INTRODUCTION: Analysis of alleged neurogenic thoracic outlet syndrome (NTOS) following motor vehicle collisions (MVC) showed a high rate of incorrect diagnosis. METHODS: Over ten years we saw 263 alleged NTOS following a MVC. Fifty-six (21.3%) had ulnar entrapment syndrome (UES) proved by nerve conduction studies or specific motor weakness. Diagnostic errors were examined. RESULTS: Inadequate physical examination and poor knowledge of neuroanatomy in 56 (100...
March 16, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29558408/diagnosing-thoracic-outlet-syndrome-current-approaches-and-future-directions
#7
REVIEW
Sebastian Povlsen, Bo Povlsen
The diagnosis of thoracic outlet syndrome (TOS) has long been a controversial and challenging one. Despite common presentations with pain in the neck and upper extremity, there are a host of presenting patterns that can vary within and between the subdivisions of neurogenic, venous, and arterial TOS. Furthermore, there is a plethora of differential diagnoses, from peripheral compressive neuropathies, to intrinsic shoulder pathologies, to pathologies at the cervical spine. Depending on the subdivision of TOS suspected, diagnostic investigations are currently of varying importance, necessitating high dependence on good history taking and clinical examination...
March 20, 2018: Diagnostics
https://www.readbyqxmd.com/read/29504475/morbidity-of-first-rib-resection-in-the-surgical-repair-of-thoracic-outlet-syndrome
#8
Kevin T Jubbal, Dmitry Zavlin, Joshua D Harris, Shari R Liberman, Anthony Echo
BACKGROUND: Thoracic outlet syndrome (TOS) is a complex entity resulting in neurogenic or vascular manifestations. A wide array of procedures has evolved, each with its own benefits and drawbacks. The authors hypothesized that treatment of TOS with first rib resection (FRR) may lead to increased complication rates. METHODS: A retrospective case control study was performed on the basis of the National Surgical Quality Improvement Program database from 2005 to 2014...
March 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29497457/neurogenic-thoracic-outlet-syndrome-caused-by-vascular-compression-of-the-brachial-plexus-a-report-of-two-cases
#9
Amgad Hanna, Larry O'Neil Bodden, Gabriel R L Siebiger
Thoracic outlet syndrome (TOS) is caused by compression of the brachial plexus and/or subclavian vessels as they pass through the cervicothoracobrachial region, exiting the chest. There are three main types of TOS: neurogenic TOS, arterial TOS, and venous TOS. Neurogenic TOS accounts for approximately 95% of all cases, and it is usually caused by physical trauma (posttraumatic etiology), chronic repetitive motion (functional etiology), or bone or muscle anomalies (congenital etiology). We present two cases in which neurogenic TOS was elicited by vascular compression of the inferior portion of the brachial plexus...
January 2018: Journal of Brachial Plexus and Peripheral Nerve Injury
https://www.readbyqxmd.com/read/29421422/influence-of-body-weight-on-surgical-treatment-for-neurogenic-thoracic-outlet-syndrome
#10
J Westley Ohman, Ahmmad A Abuirqeba, Senthil N Jayarajan, Joshua Balderman, Robert W Thompson
BACKGROUND: Body weight affects outcomes of surgical treatment for various conditions, but its effects on the treatment of neurogenic thoracic outlet syndrome (NTOS) are unknown. The purpose of this study was to evaluate the influence of body weight on technical and functional outcomes of surgical treatment for NTOS. METHODS: A retrospective review of prospectively collected data was conducted for 265 patients who underwent supraclavicular decompression for NTOS between January 1, 2014 and March 31, 2016...
February 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29401331/supraclavicular-thoracic-outlet-decompression-in-the-high-performance-military-population
#11
Joseph M White, Andrew J Soo Hoo, Scott R Golarz
Background: Neurogenic thoracic outlet syndrome (nTOS) is a relatively common disorder and often affects younger, physically active populations. The modern American military is a population at risk for the development of nTOS given the intense physical training requirements. The purpose of this study is to determine functional recovery in the active duty military population resulting in full, unrestricted return-to-duty status following supraclavicular thoracic outlet decompression with partial first rib resection, partial anterior scalenectomy, and brachial plexus neurolysis...
January 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29396981/novel-surgical-approach-for-decompression-of-the-scalene-triangle-in-neurogenic-thoracic-outlet-syndrome
#12
Robert R Hagan, Joseph A Ricci, Kyle R Eberlin
Thoracic outlet syndrome (TOS) is a cause of upper extremity and shoulder dysfunction. TOS can present with a wide range of symptoms due to compression of the brachial plexus or its branches during their passage through the cervicothoracobrachial region or scalene triangle. There are three types of TOS: arterial, venous, and neurogenic. Neurogenic TOS (nTOS) is by far the most frequent type and represents more than 95% of all cases. Historically, surgical intervention for all types of TOS has evolved based on the treatment for a vascular etiology and has typically included a first rib resection...
February 2, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29388461/the-infraclavicular-approach-for-paget-schroetter-syndrome
#13
REVIEW
G Samoila, C P Twine, I M Williams
Introduction Paget-Schroetter syndrome is a rare effort thrombosis of the axillary-subclavian vein, mainly occurring in young male patients. Current management involves immediate catheter directed thrombolysis, followed by surgical decompression of the subclavian vein. This has been invariably performed using a transaxillary or supraclavicular approach. However, the subclavian vein crosses the first rib anteriorly just behind the manubrium and can also be accessed via an infraclavicular incision. Methods MEDLINE® and Embase™ were searched for all studies on outcomes in patients undergoing infraclavicular first rib resection for treatment of Paget-Schroetter syndrome...
February 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29360741/a-patient-centered-approach-to-guide-follow-up-and-adjunctive-testing-and-treatment-after-first-rib-resection-for-venous-thoracic-outlet-syndrome-is-safe-and-effective
#14
Colin P Ryan, Nicolas J Mouawad, Patrick S Vaccaro, Michael R Go
Controversies in the treatment of venous thoracic outlet syndrome (VTOS) have been discussed for decades, but still persist. Calls for more objective reporting standards have pushed practice towards comprehensive venous evaluations and interventions after first rib resection (FRR) for all patients. In our practice, we have relied on patient-centered, patient-reported outcomes to guide adjunctive treatment and measure success. Thus, we sought to investigate the use of thrombolysis versus anticoagulation alone, timing of FRR following thrombolysis, post-FRR venous intervention, and FRR for McCleery syndrome (MCS) and their impact on patient symptoms and return to function...
January 23, 2018: Diagnostics
https://www.readbyqxmd.com/read/29336398/concomitant-neurogenic-and-vascular-thoracic-outlet-syndrome-due-to-multiple-exostoses
#15
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
#16
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
#17
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
#18
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...
March 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29241462/-neurogenic-thoracic-outlet-syndrome
#19
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
#20
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...
February 2018: World Neurosurgery
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