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Neurogenic thoracic outlet syndrome treatment by the supraclavicular approach.
[thoracic outlet syndrome]
Thoracic
outlet
syndrome
refers
to
compression
of
one
or
more
of
the
neurovascular
structures
traversing
the
superior
aperture
of
the
thoracic
cavity
.
A
symptom-based
patient-directed
questionnaire
was
used
to
evaluate
the
outcome
of
the
supraclavicular
approach
for
treatment
of
neurogenic
thoracic
outlet
syndrome
.
A
prospective
study
was
performed
between
April
2007
and
October
2010
.
During
this
period
,
97
patients
in
different
age
groups
,
with
signs
and
symptoms
of
thoracic
outlet
syndrome
,
were
surgically
treated
by
the
supraclavicular
approach
.
The
patients
were
aged
between
14
and
60
years
(
mean
32
.
5
years
)
,
and
the
majority
were
female
(
89
.
69
%
)
.
Surgery
was
performed
on
the
left
side
in
52
patients
and
on
the
right
side
in
48
,
including
3
who
had
bilateral
operations
.
The
median
follow-up
was
11
.
2
months
.
In
78
%
of
the
100
operations
,
excellent
improvement
in
symptoms
was
noted
,
there
was
partial
improvement
in
18
%
,
and
4
%
resulted
in
no
response
.
First
rib
resection
remains
an
important
and
essential
step
in
the
management
of
the
thoracic
outlet
syndrome
,
in
the
absence
of
bony
abnormalities
.
The
supraclavicular
approach
can
be
employed
with
minimal
morbidity
and
an
excellent
outcome
.
