Role of scalenotomy in the management of thoracic outlet compression syndrome

ABSTRACT

Twenty patients suffering from manifestations of thoracic outlet compression were selected from a larger group, on the basis that they are not having any generalized disease that causes nerve lesions, and with radiological evidence of the absence of cervical ribs or any cervical vertebral region disease. Clinical evaluation and electro- conductivity studies revealed proximal compression. There was an associated distal compression of the median nerve in the carpal tunnel in 33.8% of limbs studied. The disease was bilateral in four patients. 80% of cases were females. Presentation by vascular manifestations was noticed in 40% of the patients. Scalenotomy and release of carpal tunnel were done in associated lesions in the same sitting. Scalenotomy alone was done to all other cases. Results were satisfactory and no remarkable complications were detected. Electrophysiological evaluation of the median and ulnar nerves, both proximally and distally, is of great help in both diagnosis and follow up of patients after surgery