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Neurogenic thoracic outlet and pectoralis minor syndromes in children.
[thoracic outlet syndrome]
Brachial
plexus
compression
(
BPC
)
occurs
above
the
clavicle
as
neurogenic
thoracic
outlet
syndrome
(
NTOS
)
and
below
as
neurogenic
pectoralis
minor
syndrome
(
NPMS
)
.
It
was
recently
noted
that
75
%
of
the
adults
seen
for
NTOS
also
had
NPMS
and
in
some
this
was
the
only
diagnosis
.
This
is
also
true
in
children
but
has
not
yet
been
reported
.
Because
surgical
treatment
of
NPMS
is
a
minimum
risk
operation
for
pectoralis
minor
tenotomy
(
PMT
)
,
recognition
of
NPMS
and
distinguishing
it
from
NTOS
becomes
important
.
In
this
study
,
40
operations
,
20
PMT
and
20
NTOS
procedures
,
were
performed
.
Success
rate
for
PMT
was
85
%
and
for
thoracic
outlet
decompression
was
70
%
.
It
was
concluded
that
in
children
,
as
in
adults
,
BPC
is
more
often
due
to
combined
NTOS
and
NPMS
.
Surgical
PMT
should
be
considered
first
as
the
treatment
of
choice
for
children
with
NPMS
.
Thoracic
outlet
decompression
is
available
if
PMT
is
unsuccessful
.