Surgical Updates on Thoracic Outlet Syndrome

Abstract

Thoracic outlet syndrome is a widely recognized, yet highly disputed, syndrome mostly affecting structures of the thoracic outlet, including the brachial plexus, subclavian artery, and subclavian vein. Surgical decompression in the form of first rib resection with scalenectomy remains the mainstay of treatment particularly for venous and arterial thoracic outlet syndrome. This review serves as an update of recent publications/updates in the literature. Approaches to operative management continue to evolve as minimally invasive techniques have increased in popularity. Diagnostic techniques continue to evolve, particularly with regard to neurogenic thoracic outlet syndrome, to allow for more timely and accurate diagnosis. Conservative management strategies, such as anterior scalene muscle blocks, are utilized with increasing frequency, although their long-term outcomes remain unclear. The aim of the present work is to review updates in the diagnosis and management of thoracic outlet syndrome over the last decade, and discuss utility and outcomes of various strategies.