Abstract
Thoracic outlet syndrome comprises a group of disorders that result in compression of the brachial plexus and subclavian vessels exiting the thoracic outlet. Symptoms include pain, paresthesia, pallor, and weakness depending upon the compromised structures. While consensus in diagnostic criteria has not yet been established, a thorough patient history, physical exam, and appropriate imaging studies are helpful in diagnosis. General first-line therapy for thoracic outlet syndrome is a conservative treatment, and may include physical therapy, lifestyle modifications, NSAIDs, and injection therapy of botulinum toxin A or steroids. Patients who have failed conservative therapy are considered for surgical decompression. This article aims to review the epidemiology, etiology, relevant anatomy, clinical presentations, diagnosis, and management of thoracic outlet syndrome.
Highlights
Thoracic outlet syndrome (TOS) is usually subclassified into neurogenic TOS (nTOS), venous TOS (vTOS), and arterial TOS (aTOS). nTOS arises from compression of the brachial plexus and comprises the majority of TOS cases, making up for 95% of all diagnosed cases. vTOS and aTOS stem from compression of the subclavian vessels and comprise roughly 4% and 1% of TOS cases, respectively [5]
TOS stems from compression of the neurovasculature in the thoracic outlet and can be subdivided into nTOS, vTOS, and aTOS based on the relevant compromised structures and corresponding clinical presentations
The most common cause of TOS is neck trauma, which can arise due to whiplash injuries sustained during a motor vehicle collision
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. TOS can be caused by congenital, acquired, or traumatic factors, some degree of trauma is usually seen in a majority of TOS cases [4]. Diagnosis depends upon both knowledge of the patient’s existing risk factors as well as their clinical presentation and may be confirmed with physical exam maneuvers, radiographic imaging, or vascular studies. This article is based on previously conducted studies and does not contain any studies with human participants or animals performed by any of the authors. It did not need any approval by the Ethics Committee
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