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The role of congenital malformations of the thoracic outlet in the development of the syndrome
Affiliations- Department of Sensory Organs, “Sapienza” University of Rome, Italy
- Neurosurgery Unit, Dell’Angelo Hospital, Mestre, Venice, Italy
- Department of Surgical Sciences, University of Perugia, Italy
- Department of Surgical Sciences, Sapienza University of Rome, Italy
- Unit of Radiology Regina Coeli, Rome, Italy
- Department of Biomedicine and Preventive Medicine, Tor Vergata University of Rome, Italy
- Department of Drug Chemistry and Technology, “Sapienza” University of Rome, Italy
open access
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.
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 articleTitle
The role of congenital malformations of the thoracic outlet in the development of the syndrome
Journal
Issue
Article type
Original article
Pages
117-123
Published online
2020-12-30
Page views
5908
Article views/downloads
1667
DOI
Pubmed
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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