Thoracic outlet syndrome

ABSTRACT

15 cases of Thoracic outlet syndrome were included in this study, 12 patients were females and 3 were males, their ages ranged from 23-48 years with a mean age of [39.3] years. 6 cases [4%] were due to bony compression and 9 cases [60%] were due to soft tissue compression. All these cases failed to respond to conservative treatment.In 6 cases resection of the first rib by transaxilary approach with scalenectomy. For both scalenus anticus and scalenus medius. was done. In 5 cases resection of a cervical rib with scalenectomy-for scalenus Anticus-was done by supraclavicular approach. Scalenectomy-for scalenus anticus only was done in 4 cases. In 10 cases [66.7%] the results were excellent with complete recovery of the symptoms, in one patient the improvement was not complete with persistence of mild paresthesia and pain on the ulnar side of the arm and there was no improvement in 4 patients. Pneumothorax developed in 4 patients in the post-operative period but completely recovered with intercostal tube drainage. In conclusion treatment of thoracic outlet syndrome is stilI a challenging problem we believe that accurate clinical diagnosis, adequate investigation by venography, arteriography, electromyographic study and proper surgical intervention are the comerstone for a high degree of surgical success