Thoracic Outlet Syndrome

Thoracic Outlet Syndrome is diagnosed by physical examination findings, as well as films such as CT and MRI and measurements of nerve conduction velocities such as EMG.

What is Thoracic Outlet Syndrome?

Thoracic outlet syndrome is also called thoracic outlet syndrome. It is a syndrome that occurs as a result of compression of the nerves and vessels in the anatomy where the first rib is located with the clavicle, which we call clavicula, especially in the upper part of the thoracic cage area in the area that is combined with the neck area. The main cause of this syndrome is the compression of the vessels and nerves there, either separately or together. It manifests itself with various symptoms. If we evaluate what the causes of this are, some congenital structural disorders that occur at birth, or sometimes just due to excessive weight lifting, fibrous bands compress the vessels and nerves in that area.

What are the symptoms of thoracic outlet syndrome?

  • Pain in the shoulder or arm,
  • Numbness or bruising in the hand
  • Conditions such as one hand being colder than the other are called Thoracic Outlet Syndrome.
  • They are usually caused by a series of events involving the first rib.
  • Congenital band-shaped hard structures in this area, an abnormal rib or trauma can cause this disease.

How is thoracic outlet syndrome diagnosed?

Thoracic outlet syndrome is diagnosed by physical examination findings, as well as films such as CT and MRI and measurements of nerve conduction velocities such as EMG.

How is thoracic outlet syndrome (TOS) examination performed?

TOS Examination Types

The following methods are used for the diagnosis of thoracic outlet syndrome (TOS).

A – In the Adson test, the patient turns the head to the lesioned side, the neck is tense and a deep inspiration is performed. A decrease or disappearance of the radial pulse suggests compression of the costoclavicular area. This test has been modified so that the patient’s head is also turned to the non-lesioned side.

B – In the Halsted test (costoclavicular test, military position test) the patient stretches the shoulders backwards. This manoeuvre narrows the costoclavicular distance. A decrease or disappearance of the radial pulse indicates a positive test.

C – In the hyperabduction test described by Wright, the shoulder is hyperabducted and the elbow is flexed 180 degrees. The appearance of symptoms in the hand and arm indicates that the test is positive.

D – The Roos test (EAST – elevated arm stress test) involves 90 degrees of shoulder abduction and external rotation of the diseased arm. The patient is instructed to open and close the hand for 3 minutes. The appearance of symptoms indicates a positive test.

What are the treatment methods for thoracic outlet syndrome?

The treatment of thoracic outlet syndrome includes some physical therapy exercises and medications that strengthen the nerve structures and prevent blood clotting in the vein. In cases where there is no adequate response, the surgical method, i.e. thoracic outlet syndrome surgery, is considered.

Thoracic Outlet Syndrome surgery is performed to correct pathology in the upper part of the rib cage, usually in the first rib.

Why do I need surgery for thoracic outlet syndrome?

This surgery is performed to correct pathology in the upper part of the rib cage, usually in the first rib.

What are the methods of thoracic outlet syndrome surgery?

In the operation, the bands that cause compression in the upper neck are released and the first rib is removed. For this, either an incision under the armpit or an incision over the collarbone is used.

What are the risks of thoracic outlet syndrome surgery?

Injuries to blood vessels and nerves may occur. Recurrence of the disease may also be possible. The risk rate is extremely low after operations performed by an experienced surgical team and experienced doctors who have performed thoracic outlet syndrome surgery many times before.

How many days should I stay in hospital after thoracic outlet syndrome surgery?

Usually a 3-day hospital stay is sufficient.

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