Thoracic outlet syndrome

Abstract

Purpose of review: Thoracic outlet syndrome continues to be a difficult clinical entity to diagnose and treat. This review aims to discuss the diagnosis, treatment, and clinical outcomes of thoracic outlet syndrome in the recent literature. Recent findings: Clinical history, physical examination, and diagnostic studies are important in the diagnosis of thoracic outlet syndrome. Recent reports question the utility of electrodiagnostic modalities (somatosensory evoked potentials and motor evoked potentials) in assisting with the diagnosis. Surgical decompression remains the definitive treatment, with good clinical outcomes ranging from 50–95%. Success rates of surgery are decreased in patients with symptoms present for longer than 2 years before surgery and in patients who have previously undergone surgical treatment of thoracic outlet syndrome. Summary: Recognizing the signs and symptoms of thoracic outlet syndrome facilitates prompt diagnosis and treatment. Surgical decompression consisting of first rib resection and release of the scalene musculature can provide relief of the pain, weakness, and paraesthesias that define this complex syndrome. Postoperative range-of-motion exercises prevent scar formation and recurrence of symptoms.