open access

Vol 81, No 1 (2022)
Original article
Submitted: 2020-09-24
Accepted: 2020-12-02
Published online: 2020-12-30
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The role of congenital malformations of the thoracic outlet in the development of the syndrome

M. Artico1, M. T. Santarelli1, G. Stevanato2, R. Cirocchi3, V. D'Andrea4, A. Nicolai1, G. Cialone5, G. Monteleone6, I. Pindinello7, S. Taurone1
DOI: 10.5603/FM.a2020.0152
·
Pubmed: 33438186
·
Folia Morphol 2022;81(1):117-123.
Affiliations
  1. Department of Sensory Organs, “Sapienza” University of Rome, Italy
  2. Neurosurgery Unit, Dell’Angelo Hospital, Mestre, Venice, Italy
  3. Department of Surgical Sciences, University of Perugia, Italy
  4. Department of Surgical Sciences, Sapienza University of Rome, Italy
  5. Unit of Radiology Regina Coeli, Rome, Italy
  6. Department of Biomedicine and Preventive Medicine, Tor Vergata University of Rome, Italy
  7. Department of Drug Chemistry and Technology, “Sapienza” University of Rome, Italy

open access

Vol 81, No 1 (2022)
ORIGINAL ARTICLES
Submitted: 2020-09-24
Accepted: 2020-12-02
Published online: 2020-12-30

Abstract

Background: Thoracic outlet syndrome (TOS) represents a clinical condition caused by compression of the neurovascular structures that cross the thoracic outlet. TOS can be classified in: 1) neurogenic TOS (NTOS), 2) venous TOS (VTOS), 3) arterial TOS (ATOS). Many different causes can determine the syndrome: congenital malformations, traumas, and functional impairments.
Materials and methods: This manuscript reviews how the congenital malformations play an important role in adult age; however, TOS also affects patients of all ages.
Results: Radiological imaging like X-ray (radiography), magnetic resonance and computed tomography can provide useful information to assess TOS causes and decide a potential surgery. 79% of the patients included in the first two stages of nerve, artery, vein (NAV) staging experienced excellent results with kinesiotherapy; whereas patients included in the third and fourth stage of NAV staging were subject to surgery.
Conclusions: The treatment of acute forms of TOS involves thrombolysis and anticoagulant therapy; surgery is appropriate for true NTOS, vascular TOS and in some cases when conservative treatment fails.

Abstract

Background: Thoracic outlet syndrome (TOS) represents a clinical condition caused by compression of the neurovascular structures that cross the thoracic outlet. TOS can be classified in: 1) neurogenic TOS (NTOS), 2) venous TOS (VTOS), 3) arterial TOS (ATOS). Many different causes can determine the syndrome: congenital malformations, traumas, and functional impairments.
Materials and methods: This manuscript reviews how the congenital malformations play an important role in adult age; however, TOS also affects patients of all ages.
Results: Radiological imaging like X-ray (radiography), magnetic resonance and computed tomography can provide useful information to assess TOS causes and decide a potential surgery. 79% of the patients included in the first two stages of nerve, artery, vein (NAV) staging experienced excellent results with kinesiotherapy; whereas patients included in the third and fourth stage of NAV staging were subject to surgery.
Conclusions: The treatment of acute forms of TOS involves thrombolysis and anticoagulant therapy; surgery is appropriate for true NTOS, vascular TOS and in some cases when conservative treatment fails.

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Keywords

brachial plexus, subclavian artery, subclavian vein, neuromuscular bundle, first rib, anterior and middle scalene muscle, congenital malformation, clinical grading, interscalene triangle, costoclavicular triangle

About this article
Title

The role of congenital malformations of the thoracic outlet in the development of the syndrome

Journal

Folia Morphologica

Issue

Vol 81, No 1 (2022)

Article type

Original article

Pages

117-123

Published online

2020-12-30

Page views

1134

Article views/downloads

768

DOI

10.5603/FM.a2020.0152

Pubmed

33438186

Bibliographic record

Folia Morphol 2022;81(1):117-123.

Keywords

brachial plexus
subclavian artery
subclavian vein
neuromuscular bundle
first rib
anterior and middle scalene muscle
congenital malformation
clinical grading
interscalene triangle
costoclavicular triangle

Authors

M. Artico
M. T. Santarelli
G. Stevanato
R. Cirocchi
V. D'Andrea
A. Nicolai
G. Cialone
G. Monteleone
I. Pindinello
S. Taurone

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